Assessing the impact of day programs on individuals living with dementia and their family/friend caregivers (AIDA-DemCare): protocol of a prospective cohort study combined with a qualitative evaluation.

Background: Persons with dementia, their family/friend caregivers, and health systems agree that the preferred place of dementia care is a person's home. Health systems have struggled to provide sufficient community-based dementia care supports, negatively affecting the health and well-being of persons with dementia and their caregivers. Therefore, dementia care and support of dementia caregivers are critical public health priorities.

Creating a Clinical Care Pathway for Depressive Symptoms and Disorders in Long-Term Care: A Modified Delphi Process.

Objectives: To create an evidence- and expert-informed clinical care pathway focused on identifying and treating depressive symptoms and disorders in long-term care (LTC) residents.

Design: Modified Delphi survey.

Setting And Participants: Delphi participants were LTC health care providers, LTC administrators, friend/family caregivers of residents living in LTC, and residents of LTC.

Translation, adaptation, and psychometric assessment of the Alberta Context Tool for use with nurses in adult acute care in Japan.

Aim: Currently, there is no Japanese tool to measure organizational context factors that influence nurses' implementation of evidence-based practices. This study aimed to translate, culturally adapt, and psychometrically evaluate the Alberta Context Tool (ACT) for nurses in Japan.

Methods: We completed forward translations with reconciliation, expert discussions, back translations with reconciliation, back translation review by tool developers, and semi-structured cognitive interviews with verbal probing.

Contextual Action Theory in Nursing Home Settings: A Conceptual Framework for Considering the Active Role of Residents.

Nursing home (NH) residents are often considered passive recipients of care with a limited role in shaping their experience. This perspective is often reproduced in NH research, which restricts resident participation, thereby upholding ageist views that cause discrimination of older adults living in NH settings. In this article, we propose using Contextual Action Theory (CAT) as a conceptual framework for exploring NH experiences in a way that incorporates the active role of residents.

Facility-Level Variation of Resident Loneliness in Assisted Living and Associated Organizational Context Factors: A Repeated Cross-Sectional Study.

Background And Objectives: Loneliness is common among nursing home residents, and it is also thought to be a problem in assisted living (AL). However, we lack research on loneliness in AL. Our objectives were to assess changes in risk-adjusted prevalence of loneliness in AL, and facility-level variations in loneliness before and during the COVID-19 pandemic, and facility-level factors associated with AL resident loneliness during the pandemic.

Measurement invariance and differential item functioning of a care staff proxy measure of nursing home resident dementia-specific quality of life (DEMQOL-CH): do care aides' first language, and care aides' and residents' ethno-cultural background matter?

Quality of life (QoL) is a priority goal of dementia care, but measuring QoL becomes increasingly difficult as a person's ability to self-report declines. QoL measurement is particularly challenging among Nursing home (NH) residents, due to their often advanced cognitive impairment. The DEMQOL-CH is a validated tool to assess NH residents' QoL, using care staff proxy reports.

Evidence pointing toward invalidity of the SF-8 physical and mental scales: a fusion validity assessment.

Background: The SF-8™ Short Form Health Survey creates physical and mental health scale scores from responses to eight survey questions. These widely used scales demonstrate reasonable reliablity, and some forms of validity but have not been assessed for fusion validity. We assess the fusion validity of the SF-8 physical and mental health scales, and provide comments assisting fusion validity assessment of other scales.

(Re)conceptualising Good Care in Hospital Settings From the Perspectives of Older Persons: A Concept Analysis Using Pragmatic Utility.

Purpose: To understand good care from the perspective of hospitalised older persons.

Background: Older persons are the largest group of hospital users, and numbers will increase in the next decades. Hospital organisations are attempting to transform traditional care models to meet the specialised needs of hospitalised older persons.

Association Between Organizational Context and Resident Pain in Assisted Living: A Repeated Cross-Sectional Study.

Objectives: Resident pain has been a common quality challenge in congregate care for older adults, and organizational context may explain variations in resident pain beyond resident-level factors. Most studies have focused on nursing homes (NHs), largely neglecting assisted living (AL). AL residents are at similar risk for pain as NH resident, but with AL providing fewer services and staffing resources.

Adult day programs and their effects on individuals with dementia and their caregivers (ADAPT-DemCare): a realist synthesis to develop program theories on the how and why.

Background: Adult day programs aim to facilitate aging in place by supporting the health and well-being of persons with dementia and providing respite to their caregivers. However, studies on the effects of day programs are inconclusive, and we especially lack insights into the context conditions and mechanisms of day programs that may produce different outcomes for different groups of persons with dementia and their caregivers. Our objective was to conduct a realist review, synthesizing research on day programs to develop program theories explaining how and why day programs do or do not produce positive or negative outcomes for different groups of persons with dementia, and caregivers.

EXploring Patterns of Use and Effects of Adult Day Programs to Improve Trajectories of Continuing Care (EXPEDITE): Protocol for a Retrospective Cohort Study.

Background: Adult day programs provide critical supports to older adults and their family or friend caregivers. High-quality care in the community for as long as possible and minimizing facility-based continuing care are key priorities of older adults, their caregivers, and health care systems. While most older adults in need of care live in the community, about 10% of newly admitted care home residents have relatively low care needs that could be met in the community with the right supports.

Associations between specialized dementia care, COVID-19 and central nervous system medication use in assisted living: a population-based repeated cross-sectional study.

Background: Assisted living (AL) is an increasingly common residential setting for persons with dementia; yet concerns exist about sub-optimal care of this population in AL given its lower levels of staffing and services. Our objectives were to (i) examine associations between AL setting (dementia care vs. other), COVID-19 pandemic waves, and prevalent antipsychotic, antidepressant, anti-dementia, benzodiazepine, and anticonvulsant drug use among residents with dementia/cognitive impairment, and (ii) explore associations between resident and home characteristics and prevalent medication use.

How context links to best practice use in long-term care homes: a mixed methods study.

Background: Context (work environment) plays a crucial role in implementing evidence-based best practices within health care settings. Context is multi-faceted and its complex relationship with best practice use by care aides in long-term care (LTC) homes are understudied. This study used an innovative approach to investigate how context elements interrelate and influence best practice use by LTC care aides.

Excess Deaths in Assisted Living and Nursing Homes during the COVID-19 Pandemic in Alberta, Canada.

Objectives: Assisted living (AL) is a significant and growing congregate care option for vulnerable older adults designed to reduce the use of nursing homes (NHs). However, work on excess mortality in congregate care during the COVID-19 pandemic has primarily focused on NHs with only a few US studies examining AL. The objective of this study was to assess excess mortality among AL and NH residents with and without dementia or significant cognitive impairment in Alberta, Canada, during the first 2 years of the COVID-19 pandemic, relative to the 3 years before.

Contextually appropriate nurse staffing models: a realist review protocol.

Introduction: Decisions about nurse staffing models are a concern for health systems globally due to workforce retention and well-being challenges. Nurse staffing models range from all Registered Nurse workforce to a mix of differentially educated nurses and aides (regulated and unregulated), such as Licensed Practical or Vocational Nurses and Health Care Aides. Systematic reviews have examined relationships between specific nurse staffing models and client, staff and health system outcomes (eg, mortality, adverse events, retention, healthcare costs), with inconclusive or contradictory results.

The Association of Nursing Homes' Organizational Context With Care Aide Empowerment: A Cross-Sectional Study.

Background And Objectives: Organizational context is thought to influence whether care aides feel empowered, but we lack empirical evidence in the nursing home sector. Our objective was to examine the association of features of nursing homes' unit organizational context with care aides' psychological empowerment.

Research Design And Methods: This cross-sectional study analyzed survey data from 3765 care aides in 91 Western Canadian nursing homes.

Organizational Context and Facilitation Interactions on Delirium Risk in Long-Term Care: A Cross-Sectional Study.

Objectives: Organizational context (eg, leadership) and facilitation (eg, coaching behaviors) are thought to interact and influence staff best practices in long-term care (LTC), including the management of delirium. Our objective was to assess if organizational context and facilitation-individually, and their interactions-were associated with delirium in LTC.

Design: Retrospective cross-sectional analysis of secondary data.

Counting what counts: assessing quality of life and its social determinants among nursing home residents with dementia.

Background: Maximizing quality of life (QoL) is a major goal of care for people with dementia in nursing homes (NHs). Social determinants are critical for residents' QoL. However, similar to the United States and other countries, most Canadian NHs routinely monitor and publicly report quality of care, but not resident QoL and its social determinants.

Remote visits to address loneliness for people living with dementia in care homes: A descriptive qualitative study of visitors' perceptions.

Aims: To assess visitors' perceptions of the benefits and challenges related to engaging in a remote visit intervention, which was designed to address the loneliness of people living with moderate to severe dementia in care homes.

Design: A qualitative descriptive study.

Methods: Twenty-four people living with dementia in care homes in Canada and their family and friends (i.

Factors influencing health-related quality of life among long-term care residents experiencing pain: a systematic review protocol.

Background: Pain is highly burdensome, affecting over 30% of long-term care (LTC) residents. Pain significantly reduces residents' health-related quality of life (HRQoL), limits their ability to perform activities of daily living (ADLs), restricts their social activities, and can lead to hopelessness, depression, and unnecessary healthcare costs. Although pain can generally be prevented or treated, eliminating pain may not always be possible, especially when residents have multiple chronic conditions.

Burnout Among Nursing Home Care Aides and the Effects on Resident Outcomes.

While burnout among health care workers has been well studied, little is known about the extent to which burnout among health care workers impacts the outcomes of their care recipients. To test this, we used a multi-year (2014-2020) survey of care aides working in approximately 90 nursing homes (NHs); the survey focused on work-life measures, including the Maslach Burnout Inventory (MBI) and work-unit identifier. Resident Assessment Instrument Minimum Data Set (RAI-MDS 2.

Internal structure validity and internal consistency reliability of the Minnesota Living with Heart Failure Questionnaire: a systematic review protocol.

Introduction: The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most used tools to measure health-related quality of life in heart failure. Despite extensive use in research, evidence on the MLHFQ's internal structure validity remains heterogeneous and inconclusive. There are no known reviews that systematically summarise the evidence related to the MLHFQ's factor structure (internal structure validity).