[Optimising skill mix in nursing homes: Enhancing team composition and interprofessional collaboration].

In Dutch nursing homes, the number of older adults with complex care needs increases, while at the same time there is a shortage of professionals. This requires changes in the organisation of care in order to provide appropriate care. The aims of this study were to generate knowledge about: 1) how team composition and interprofessional collaboration influence each other and 2) the development and implementation of optimal skill mix in nursing homes.

Tailored interventions for inappropriate psychotropic drug use in nursing home residents with dementia: participatory action research in a special case of a stepped-wedge cluster randomized controlled trial.

Background: Psychotropic drugs are modestly effective and may cause adverse effects. Efforts to reduce inappropriateness and increase usage of psychosocial interventions often suffer from suboptimal implementation. The purpose of this study was to evaluate effectiveness of an innovative study using implementation promoting elements in nursing home residents with dementia and neuropsychiatric symptoms.

Determinants of Mortality and Causes of Death in Patients With Dementia and Very Severe Challenging Behavior.

Objectives: To gain insight into the mortality over time of patients with very severe challenging behavior in dementia when they are temporarily admitted to highly specialized units for treating the behavior.

Design: Observational study.

Setting And Participants: Eleven highly specialized units throughout the Netherlands participated from December 2020 until December 2022, with a follow-up in September 2023, with 127 patients participating.

Patient characteristics, behavior, and discharge locations of patients with dementia and very severe challenging behavior.

Objectives: To gain insights into the characteristics, behavior, and discharge location of patients with dementia and very severe challenging behavior admitted to highly specialized units that are specialized in the diagnostics and treatment of this patient group.

Method: In this observational study, 11 units participated from 2020 - 2023. Measurements included demographics; dementia type; severity of cognitive decline; presence of delirium; location before admission; compulsory admission; medical history; drug use; and behavior during the first 2 weeks of admission, assessed by the Cohen-Mansfield Agitation Inventory and the Neuropsychiatric Inventory Questionnaire.

How is autonomy supported for people with dementia living in a nursing home, to what extent and under what circumstances? A realist evaluation.

Background: Being autonomous is important for people with dementia living in nursing homes. Our recent realist review indicated that supporting their autonomy depends on various aspects.

Objective: This study aimed to uncover how people with dementia, their family members and care and treatment professionals experience the support of autonomy in daily care practice: what works, to what extent and under what circumstances.

Development and Validation of the EBP-Affinity Questionnaire: A Mixed-Method Study.

Background: Implementation of evidence-based practice (EBP) in nursing homes is important to improve quality of care and reduce costs. These facilities primarily employ certified nurse assistants (CNAs) and vocationally-trained registered nurses (VTRNs). Although EBP is scarcely addressed in their education, these caregivers have an important role in EBP.

The PET@home Toolkit: A Process Evaluation Study.

The Dutch PET@home Toolkit was developed to mitigate challenges, foster conversations, and support planning concerning pets in long-term care at home. This process evaluation study aimed to evaluate the practical application of the toolkit on four topics: (1) satisfaction; (2) relevance; (3) feasibility; and (4) integration of the PET@home Toolkit materials in home care. Outcomes may be used to improve the toolkit materials to better align with the long-term care at home setting.

Exploring small stories of older adults elicited by virtual nature videos with a randomized online survey.

Objective: Counteracting feelings of loneliness among older adults underscores the need to improve social well-being, for example, by sharing small stories. Interestingly, virtual representation of nature (VN) can stimulate social aspirations and trigger associations, which could be used as conversational material. Especially nature's characteristics of mystery and spaciousness seem promising.

Organizational characteristics of highly specialized units for people with dementia and severe challenging behavior.

Background: People with dementia and severe challenging behavior in the Netherlands can be temporarily admitted to highly specialized units when their behavior is not manageable in regular dementia special care units (DSCUs). With scarce evidence available for the treatment of these patients, treatment in these units is in a pioneering phase. To gain more insight into these units, this study investigated organizational characteristics, i.

Learning From People With Dementia What Works Well for Well-Being: Interviews and Focus Groups.

Background And Objectives: Previous research has tended to prioritize the condition of dementia when investigating positive lived experiences, while there is no evidence that well-being becomes fundamentally different when living with dementia. The current exploratory qualitative study examined how people living with dementia describe how they realize their well-being, without treating dementia as a central concern, and specifically addressed people who are successful in maintaining their well-being.

Research Design And Methods: Semistructured face-to-face interviews (n = 16) and 2 focus groups (n = 13) were conducted with community-dwelling older people living with dementia, aged 65-93 years (68% male).

A bayesian network meta-analysis to explore modifying factors in randomized controlled trials: what works for whom to reduce depression in nursing home residents?

Background: Reviews of depression interventions in nursing home residents resulted in positive findings. However, because of the heterogeneity of the studies, it remains unclear what works for whom. Considering moderator effects may contribute to a comprehensive understanding of depression treatment in residents.

The development of the PET@home toolkit: An experience-based co-design method study.

Objective: The relevance of pets in long-term home care is increasingly recognised because of their effects on health outcomes in clients and the rising number of clients receiving long-term care at home (further referred to as clients receiving home care). Currently, there is a lack of supportive materials that address pet-related challenges within home care. This study aimed to develop a toolkit for clients receiving home care with pets, their family, and professional caregivers using a participatory research approach.

Personality assessment in nursing home residents with mental and physical multimorbidity: two informant perspectives.

Objectives: In older patients with mental and physical multimorbidity (MPM), personality assessment is highly complex. Our aim was to examine personality traits in this population using the Hetero-Anamnestic Personality questionnaire (HAP), and to compare the premorbid perspective of patients' relatives (HAP) with the present-time perspective of nursing staff (HAP-t).

Design: Cross-sectional.

A Process Evaluation of an Antibiotic Stewardship Intervention for Urinary Tract Infections in Nursing Homes.

Objectives: To assess the internal and external validity of a cluster randomized controlled trial (cRCT) evaluating a decision tool with supportive interventions for the empirical treatment of urinary tract infections (UTIs) in nursing homes (NHs), and to identify facilitators and barriers in implementing this antibiotic stewardship intervention.

Design: Mixed-methods process evaluation study.

Setting And Participants: Physicians, nursing staff, client council members, and residents of Dutch NHs.

Transferring people with dementia to severe challenging behavior specialized units, an in-depth exploration.

Objectives: One of the main reasons for people with dementia to move to a dementia special care unit of a nursing home is challenging behavior. This behavior is often difficult to manage, and in the Netherlands, residents are sometimes relocated to a severe challenging behavior specialized unit. However, relocation often comes with trauma and should be prevented if possible.

Identifying and managing apathy in people with dementia living in nursing homes: a qualitative study.

Background: Although apathy is common in people with dementia and has profound negative effects, it is rarely diagnosed nor specifically treated in nursing homes. The aim of this study is to explore experiences in identifying and managing apathy from the perspectives of people with dementia and apathy (PwA), family caregivers (FCs) and professional caregivers (PCs).

Methods: Descriptive qualitative study with purposive sampling, comprising eleven semi-structured in-depth interviews with PwA, FCs or PCs and focus groups with twelve PCs in Dutch nursing homes.

Evaluation of the SPAN intervention for people living with young-onset dementia in the community and their family caregivers: a randomized controlled trial.

Objectives: To evaluate the effectiveness of the SPAN-intervention, a psychosocial intervention aiming at improving a sense of usefulness and engaging in meaningful activities, for community-dwelling people living with young-onset dementia (YOD) and their family caregivers.

Methods: A cluster-randomized controlled trial with two parallel groups (SPAN-intervention vs. care as usual) with assessments at baseline and five-month follow-up was performed.

The development and feasibility evaluation of a program to identify and manage apathy in people with dementia: the SABA program.

Objectives: To develop and evaluate feasibility of a program for family and professional caregivers to identify and manage apathy in people with dementia: the Shared Action for Breaking through Apathy program (SABA).

Methods: A theory- and practice-based intervention was developed and tested among ten persons with apathy and dementia in two Dutch nursing homes from 2019 to 2021. Feasibility was evaluated with interviews with family caregivers ( = 7) and professional caregivers ( = 4) and two multidisciplinary focus groups with professional caregivers ( = 5 and  = 6).

After COVID-19 vaccinations: what does living and working in nursing homes look like?

Background: Nursing homes were disproportionally affected by the COVID-19 pandemic. Vaccination was considered critical for the normalization of daily live of nursing home residents. The present study investigates the impact of the prolonged COVID-19 pandemic and the effect of vaccinations on the daily lives of residents and staff in Dutch nursing homes.

Supporting Resilience of Older Adults with Cognitive Decline Requires a Multi-Level System Approach.

The concept of resilience, i.e., the capacity of a system to bounce back after a stressor, is gaining interest across many fields of science, policy, and practice.

Well-being, multidisciplinary work and a skillful team: essential elements of successful treatment in severe challenging behavior in dementia.

Objective: Conceptualize successful treatment of persons with dementia and severe challenging behavior as perceived by professionals.

Methods: In this concept mapping study 82 experts in dementia care participated. The study followed two phases of data collection: (1) an online brainstorm where participants completed the focus prompt: '; (2) individual sorting and rating of the collected statements followed by data analysis using multidimensional scaling and hierarchical cluster analysis, resulting in a concept map.

[Dementia knowledge assessment for nurses and care workers: a psychometric description of measuring instruments as a guideline for Dutch practice].

A condition for good quality care for people with dementia is that nurses and carers have sufficient knowledge of dementia. To test this knowledge, to measure the effects of psychosocial interventions and to develop educational programs, knowledge tests for dementia have been developed. This review examined which knowledge tests are available for nurses and care workers.

[Remote work and the use of online communication in nursing homes during COVID-19-measures].

The measures taken in Dutch nursing homes during the first wave of the COVID-19 pandemic resulted in both an increase and a decrease of challenging behavior in nursing home residents. Staff undertook various initiatives to reduce the negative effects. For example, video calling between residents and their relatives was facilitated.