ABSTRACT
BACKGROUND: Observational tools can support the understanding of the complex needs of older people with dementia and aid delivery of person-centred care. However, existing tools are complex and resource intensive to use. OBJECTIVES: To develop and evaluate the acceptability and feasibility of a low-resource, observational tool to support staff reflection and practice development. METHODS: Intervention development of the Person-Centred Observation and Reflection Tool (PORT) and acceptability and feasibility study, using surveys and focus groups in the UK, Norway and Spain. RESULTS: PORT was reported as easy, accessible and acceptable to use. The observation was identified as powerful for individual staff development and provided an evidence-based source for underpinning individualised care planning. Potential time challenges associated with implementation were identified. CONCLUSION: Initial evaluation indicates PORT is an acceptable and feasible tool for use in health and social care settings for older people. Further research is needed on implementation models and the impacts of PORT use. IMPLICATIONS FOR PRACTICE: PORT may be a useful tool to support individual staff development in care settings and person-centred care planning for people with dementia.
Subject(s)
Dementia , Humans , Aged , Patient-Centered Care , Focus Groups , Social Support , Surveys and QuestionnairesABSTRACT
BACKGROUND: Conventional nursing homes in Singapore adopt an institutional and medical model of care with a focus on safety and risk management. As such, less regard is placed on upholding the dignity and autonomy of the resident, which compromises quality of care and the well-being of the resident. Today, person-centred care (PCC) has become synonymous with high-quality care that sustains the well-being and personhood of the care recipient. OBJECTIVES: To describe the model of PCC adopted by a nursing home, Apex Harmony Lodge (AHL), with a logic model and evaluate outcomes on residents' well-being, care quality, and staff attrition by comparing pre-PCC initiation (2015) to post-implementation (2016). METHODS: Male residents in a 30-bed assisted living facility for persons with dementia in AHL were assessed using Dementia Care Mapping. Residents' well-being and staff attrition were measured before and after PCC implementation. RESULTS: There were statistically significant improvements in resident well-being (Δ = 0.44, p = 0.029), Positive Engagement Potential (Δ = 0.17, p = 0.002), and Occupational Diversity (Δ = 0.12, p = 0.014) in 2016. Withdrawal and Passive Engagement in the residents were reduced significantly as were Care Detractors. There was also a 55% reduction in staff attrition rates post-PCC. CONCLUSIONS: Post-PCC implementation, the outcomes indicate a superior quality of care, enhanced resident well-being, and better staff retention. The AHL PCC model could serve as a roadmap for other nursing homes aspiring to raise the quality of care and influence long-term care standards and regulations for policy makers and legislators.
