Long -Term Care

In this section of the review you will find any papers that are specific to long term care. This includes the type of care provided, and issues for staff providing that care. It does not include papers on the design and building of long term care environments. These can be found in the section on housing, the built environment and ICT.

Deciding about nursing home care in dementia: A conjoint analysis of how older people balance competing goals.

Fahey, A., NíChaoimh, D., Mulkerrin, G.R., Mulkerrin, E.C. and O'Keeffe, S.T.
Geriatrics & Gerontology International.
Fahey et al. (2017) examined how older people would rank outcomes if they were to develop significant dementia, specifically where someone living at home’s cognitive function was decreasing and the decision of whether to move into care was being considered.
They found that few participants were concerned with reducing risk and lengthening life, with 28% even favouring a shorter life. The most significant concerns were remaining at home and minimising burden on family, two priorities that are an example of the difficult trade-offs that are often required. The authors highlight the value placed on remaining at home by many older people, even in challenging circumstances where there is greater risk of harm and it seems inadvisable.

Pain in Care home residents with dementia: An exploration of frequency, prescribing and relatives perspectives.

Barry, H.E., Parsons, C., Passmore, A.P. and Hughes, C.M.
International journal of geriatric psychiatry
In a study carried out in 9 nursing homes in Northern Ireland, Barry et al. (2015) found that the assessment and management of pain among residents with dementia continues to challenge care home providers and staff.
High numbers of residents were prescribed analgesics “when required” but no guidelines were in place for assessment of pain before administering and many staff were unfamiliar with observational pain assessment tools. There were also high levels of anti-psychotic prescription despite recent policy recommendations on their reduction. The authors acknowledge the limitation of a small sample size but conclude the study demonstrates a need for care providers to really focus on assessment and management of pain among their residents with dementia.