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Person-Centred Care Transformation in a Nursing Home for Residents with Dementia

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....

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Autores principales: Ho, Peiyan, Cheong, Rachel Chin Yee, Ong, Siew Pei, Fusek, Carol, Wee, Shiou Liang, Yap, Philip Lin Kiat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989831/
https://www.ncbi.nlm.nih.gov/pubmed/33790933
http://dx.doi.org/10.1159/000513069
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author Ho, Peiyan
Cheong, Rachel Chin Yee
Ong, Siew Pei
Fusek, Carol
Wee, Shiou Liang
Yap, Philip Lin Kiat
author_facet Ho, Peiyan
Cheong, Rachel Chin Yee
Ong, Siew Pei
Fusek, Carol
Wee, Shiou Liang
Yap, Philip Lin Kiat
author_sort Ho, Peiyan
collection PubMed
description 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.
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spelling pubmed-79898312021-03-30 Person-Centred Care Transformation in a Nursing Home for Residents with Dementia Ho, Peiyan Cheong, Rachel Chin Yee Ong, Siew Pei Fusek, Carol Wee, Shiou Liang Yap, Philip Lin Kiat Dement Geriatr Cogn Dis Extra Research Article 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. S. Karger AG 2021-02-02 /pmc/articles/PMC7989831/ /pubmed/33790933 http://dx.doi.org/10.1159/000513069 Text en Copyright © 2021 by S. Karger AG, Basel http://creativecommons.org/licenses/by-nc-nd/4.0/ This article is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND) (http://www.karger.com/Services/OpenAccessLicense). Usage and distribution for commercial purposes as well as any distribution of modified material requires written permission.
spellingShingle Research Article
Ho, Peiyan
Cheong, Rachel Chin Yee
Ong, Siew Pei
Fusek, Carol
Wee, Shiou Liang
Yap, Philip Lin Kiat
Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title_full Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title_fullStr Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title_full_unstemmed Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title_short Person-Centred Care Transformation in a Nursing Home for Residents with Dementia
title_sort person-centred care transformation in a nursing home for residents with dementia
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7989831/
https://www.ncbi.nlm.nih.gov/pubmed/33790933
http://dx.doi.org/10.1159/000513069
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