Resident-Directed Long-Term Care: Staff Provision of Choice During Morning Care

Purpose:  To develop an observational protocol to assess the quality of staff-resident communication relevant to choice and describe staff-resident interactions as preliminary evidence of the usefulness of the tool to assess current nursing home practices related to offering choice during morning ca...

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Bibliographic Details
Published in:The Gerontologist 2011-12, Vol.51 (6), p.867-875
Main Authors: Simmons, Sandra F., Rahman, Annie, Beuscher, Linda, Jani, Victoria, Durkin, Daniel W., Schnelle, John F.
Format: Article
Language:English
Subjects:
Activities of Daily Living
Aged
Aged, 80 and over
Agreement
Choice Behavior
Choices
Communication
Female
Geriatric Assessment - methods
Geriatric Nursing - standards
Health Facilities
Health Services
Health Services for the Aged - standards
Homes for the Aged - organization & administration
Homes for the Aged - standards
Humans
Institutionalized Persons
Interpersonal Communication
Long Term Care
Long term health care
Long-Term Care - organization & administration
Male
Measures (Individuals)
Medical personnel
Medical practices
Nursing Homes
Nursing Homes - organization & administration
Nursing Homes - standards
Observation
Practice Concepts
Quality of care
Quality of Health Care
Quality of Health Care - standards
Selection
Tennessee
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Summary:Purpose:  To develop an observational protocol to assess the quality of staff-resident communication relevant to choice and describe staff-resident interactions as preliminary evidence of the usefulness of the tool to assess current nursing home practices related to offering choice during morning care provision.  Design and Methods:  This study included 73 long-stay residents in 2 facilities. Research staff conducted observations for 4 consecutive morning hours during targeted care activities (transfer out of bed, incontinence, dressing, and dining location). Observations were conducted weekly for 12 consecutive weeks. Staff-resident interactions were measured related to staff offers of choice and residents' responses.  Results:  Interrater agreement was achieved for measures of staff offers of choice (kappa = .83, p < .001), type of choice provided (kappa = .75, p < .001), and resident requests related to choice (kappa = .72, p < .001). Observations over 2,766 care episodes during 4 aspects of morning care showed that staff offered residents choice during 18% of the episodes. Most observations (70%) were coded as staff offering "no choice."  Implications:  Nursing home staff can use a simplified version of this standardized observational tool to reliably measure staff-resident interactions related to choice during morning care provision as a first step toward improving resident-directed care practice.
ISSN:0016-9013
1758-5341
DOI:10.1093/geront/gnr066