Dementia is one of the leading risk factors for admission into a nursing home (NH) facility. In the traditional medical model, care practices are often systematic and impersonal, and there is little incentive or encouragement for nursing staff to learn about the unique needs of individual residents. In this impersonal environment, residents living with dementia (RLWD), who often lack the capacity to communicate, can be ignored. Unmet needs can lead to disruptive behavior among residents, and frustration, burnout and high turnover among nursing staff. In this study, a pretest-posttest control group quasi-experimental design was used to evaluate the effect of individualized, or person-centered Life History Collages on (1) changes in nursing staff knowledge of individual residents, and (2) nursing staff perceptions of (a) knowing the person, (b) staff to resident communication, and (c) staff to staff communication. Thirty-six nursing staff (18 intervention and 18 control) and 5 RLWD (3 intervention and 2 control) participated. Open and closed-ended questionnaires were used to collect staff (1) knowledge about individual residents, and (2) perceptions of person-centered care (PCC) practices pretest, posttest, and again at 3 weeks post-intervention. The PI utilized multivariate analysis of covariance (MANCOVA) to compare mean (1) levels of knowledge about individual RLWD, and (2) perceptions of PCC practices between the intervention and control nursing staff members posttest, and 3 weeks post-intervention, controlling for pretest levels. Analyses of covariance (ANCOVA) were used to determine the effect of collage exposure, or no collage exposure on the mean nursing staff (1) knowledge of three dependent variables: (a) family, (b) jobs/careers, and (c) past and current likes, dislikes, and interests, and 2) perceptions of (a) knowing the person, (b) staff to resident communication, and (c) staff to staff communication posttest, and 3 weeks post-intervention, controlling for pretest levels. Based on Kitwood's Theory of Personhood, improved knowledge and perceptions of RLWD may lead to improved personhood status. Elevated personhood status has strong implications for caregiving practices in the NH setting. The Personhood Model for Dementia Care is discussed to illustrate the importance of various levels of personhood, and person-centered care practices for RLWD in NH settings.
|School:||University of Arkansas for Medical Sciences|
|School Location:||United States -- Arkansas|
|Source:||DAI-B 70/04, Dissertation Abstracts International|
|Subjects:||Mental health, Nursing|
|Keywords:||Alzheimer's disease, Dementia, Nursing homes, Person-centered care, Personhood|
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