Transforming nursing home culture: Opinions of older people. A cross-sectional study in Belgium.

A culture change movement is taking place in some nursing homes: from the traditional biomedical to more person-centred and relational environments. However, knowledge of the institutional preferences of older people among the general population is limited. We focused on identifying what is important to older people when choosing a nursing home. We also wanted to determine which type of environment (traditional or relational) they would be more inclined to enter; where they would feel better cared for and respected; where professionals would offer more adequate support; where older people would feel more at home, and where they would feel freer to live the life they wanted. A cross-sectional study based on the analysis of two brochures was conducted: one integrated traditional nursing home information, the other included information related to the culture change environment. Participants (n = 71) were first asked, when choosing a nursing home, what the most important features were. They were then asked to consider the two brochures and, after reading each, to assess their desire to enter the nursing home, their feelings about the care given by the professionals, the respect of their personal habits and their choices, the professional support, the home-like atmosphere and freedom to live their life. Finally, they were asked to choose one nursing home. The features cited by the participants were then evaluated by independent evaluators to identify their orientation (traditional or culture change nursing home). The majority was assessed as having a culture change in orientation. After reading the culture change brochure, participants felt more inclined to enter the nursing home, and believed that they would be better cared for, be more respected (habits and choices), and freer to live the life they desired in a home-like atmosphere, compared to the traditional brochure. Finally, most participants chose the culture change nursing home as their final choice. The results support the potential benefits of culture change within nursing home environments.

Examining the Impact of Fictional Life Story of Resident with Dementia on Staff Levels of Empathy, Self-confidence, Workload Burden, and Perception of Resident: A Cross-sectional Survey in Long-term Care Communities.

OBJECTIVES: Determine the impact of fictional life story on staff members levels of empathy, self-confidence, workload burden, and perception of resident before the implementation of care for new resident with dementia in long-term care community. METHODS: An online cross-sectional survey based on two fictive clinical vignettes was used: one vignette described a resident with typical medical information (e.g., level of autonomy, health status, medication …), while the other contained typical medical information and life story information. The two vignettes were visually similar. The order in which vignettes were read was counterbalanced. Staff members (n = 95) were asked to consider the care needed by these residents and to assess, with a visual analogue scale, the amount of useful information provided by vignettes, their self-confidence and level of empathy, their perception of the resident's level of sympathy, his dependence, and the associated workload. RESULTS: After reading the vignette containing life story information, staff members considered that they had more useful information and empathy for the resident. They also felt more confident about the care. They perceived the resident as more sympathetic and less dependent, and the workload seemed lighter to them compared to the case described in the vignette that did not contain life story information. CONCLUSIONS: This quantitative study shows, in clinical fictive situations, the positive impact of life story on staff members before care begins. CLINICAL IMPLICATIONS: Results highlight the importance of considering life story early. Getting to know residents should be the first step of care.

[Role of "light therapy" among older adults with dementia: an overview and future perspectives]. / Place des « thérapies lumière ¼ auprès des personnes âgées souffrant de pathologie démentielle : état des lieux et perspectives futures.

Given the relatively modest therapeutic benefits of drug treatments (and their associated costs) in dementia, there is a growing interest in non pharmacological approaches, including light therapy (light based therapy, LBT). Although various literature reviews exist, little attention has been given to the effects of these therapies (according to their modalities of application) on parameters related to both circadian rhythm and clinical parameters associated with dementia. AIMS: To provide an overview of available studies using LBT as non-pharmacological approach for managing persons with dementia and to make recommendations for its use. METHOD: Systematic searches in Medline and PsycINFO were carried out, from their inception to February 2017, by means of the combination of key words including dementia and light therapy. RESULTS: Forty-two articles were reviewed with particular attention to the subjects' characteristics and the modalities of the therapy. The effect of LBT has been considered as a mean of intervention to entrain the circadian rhythm as well as in a clinical approach to reduce behavioral disorders, to reduce cognitive decline or loss of independence, and so on. Depending on the parameters and modalities, the effect of LBT is partially or non-significant. CONCLUSIONS: Based on this literature review, some recommendations were formulated: prioritizing 'naturalistic' devices, setting a minimum threshold of 2,000 lux light intensity peak, testing the modulation of the light intensity during the day and finally, assessing the adequacy between the type of light (color) and the desired therapeutic objective (relaxing or stimulating effect).