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PubMed2006

Zeitgeists and development trends in long-term care facility design.

Through literature analysis, in-depth interviews, and the application of the Delphi survey, this study explored long-term care resident priorities with regard to long-term care facility design in terms of both physical and psychological needs. This study further clarified changing trends in long-term care concepts; illustrated the impact that such changes are having on long-term care facility design; and summarized zeitgeists related to the architectural design of long-term care facilities. Results of our Delphi survey indicated the following top five priorities in long-term care facility design: (1) creating a home-like feeling; (2) adhering to Universal Design concepts; (3) providing well-defined private sleeping areas; (4) providing adequate social space; and (5) decentralizing residents' rooms into clusters. The three major zeitgeists related to long-term care facility design include: (1) modern long-term care facilities should abandon their traditional "hospital" image and gradually reposition facilities into homelike settings; (2) institution-based care for the elderly should be de-institutionalized under the concept of aging-in-place; and (3) living clusters, rather than traditional hospital-like wards, should be designed into long-term care facilities.

Activities of Daily Living↗
PubMed1995

A needs-led approach to hospital resettlement.

Reports on an inter-agency initiative in Wakefield that used a needs-led case management approach for the resettlement of 32 former users of long-term hospital mental health services. Reviews the programme using headings provided by the values which underpinned local mental health services, namely, that services should endeavour to be appropriate, acceptable, accessible, effective/efficient and equitable for service users. The main objective of the programme was achieved--32 former users of hospital mental health services were resettled. Issues were, however, raised concerning the extent to which the programme could be described as needs-led. Concludes that there is still much to learn about the application of case management within the British health context.

Community Mental Health Services↗
PubMed1998

Community health centres in Canada.

In an increasing trend, clients are being moved from tertiary and secondary care to primary care. This "down-loading", accompanied by the increasingly complex needs of clients, has forced providers and policy makers to acknowledge the importance of primary care. In exploring options for the reorganization of primary care, the characteristics of community health centres are often promoted as the model with the best potential. This article outlines a descriptive overview of community health centres (CHCs) across Canada.

Canada↗
PubMedDate not supplied

Nursing care of special populations: issues in caring for elderly people with mental retardation.

TOPIC: Changes in the life expectancy of people with mental retardation (MR) and its impact on nursing. PURPOSE: To outline issues associated with health care of an aging MR population. Advances in medicine and technology have contributed to gains in life expectancy for people with MR. Nurses, therefore, will be providing increased care for these individuals in both acute and community settings. Nurses and other healthcare providers must be educated concerning the special needs of individuals with MR. SOURCES: Review of CINAHL, MEDLINE, PUBMED, government documents, and policy papers from 1993 to 2003. CONCLUSIONS: Nurses need education and increased exposure to the special clinical challenges of caring for individuals with MR. In addition, accessible and appropriate community-based services are required to enhance the quality of life for people with MR.

Aged↗
PubMedDate not supplied

Integration of haemophilic boys into normal schools.

Advances in the medical treatment of haemophilia have made it possible for the majority of haemophilic children to attend ordinary rather than special schools. A survey carried out in the Glasgow and Edinburgh regions among families with haemophilic children and the schools which these children attend has drawn attention to certain implications of this new policy.

Absenteeism↗
PubMedDate not supplied

A move from hospital to community: evaluation of community contacts.

A small-scale evaluation was made of the activities and social contacts of a group of young mentally handicapped people in one project, leaving hospital to a house in the community. The results are consistent with other recent work in suggesting that residential provision in small homes for people with severe or profound intellectual or multiple handicaps is likely to lead to increased family contact, increased participation in activities outside of the residence, and an increased frequency and duration of contact with non-handicapped people. The study suggests that many of these benefits of life in the community are dependent in various ways upon the staff employed. The nature of the young people's social contacts is examined and conclusions are drawn about specific issues, including staff selection and training, and attention to the maintenance as well as the provision of social contact.

Activities of Daily Living↗
PubMed1991

A quality of life study of discharged long-term psychiatric patients.

A survey of 48 discharged long-stay patients was carried out. The purpose of the survey was to identify the patients' perceptions of: (a) the preparation given to them in the rehabilitation wards prior to discharge; (b) the quality of their life in the community; (c) the care given by the community psychiatric nurses. A structured interview was conducted in the ex-patient's own home and objective measures of quality of life were also used. Most patients felt that they were well prepared for discharge. More received skills training then received health education. Every respondent (48, 100%) preferred living in the community to being in a psychiatric hospital. Most respondents (46, 95%) were satisfied with life in general. Twenty-eight were visited by community psychiatric nurses and 24 (85%) were satisfied with the care given.

Adult↗
PubMed1992

Caring in the preparation of long-term psychiatric patients for non-institutional care: ethnonursing study.

Caring is the central and unifying domain for the body of knowledge and practices in nursing. It was the purpose of this ethnonursing study to describe caring in the residential training for long-term psychiatric patients in Finland in 1977-1988. Data were collected by interviewing 20 patients and 11 members of staff. On the basis of the empirical data, four stages of caring could be distinguished: formation, reformation, fragmentation and reintegration. The changes in caring occurred on the following dimensions: work for wages vs. vocation; spontaneous social interaction vs. the systematic instruction of practical skills; and collective activities vs. individual activities.

Caregivers↗
PubMed1994

Caring from the point of view of a Finnish mental health nurse: a life history approach.

Finnish mental health care went through a major change in the 1980s. Its institutions were being run down and there was a shift to a caring system that stresses non-institutional practices. The schooling and work of the mental health nurse had to adapt to the new situation. The purpose of my study was to describe and analyse the mental health nurse's work, i.e. caring, as it is experienced by a nurse in the preparation of long-term psychiatric patients for non-institutional care. The data consist of repeated interviews with Vuokko, who has been a mental health nurse for about 30 years and is now approaching her retirement. In the light of the data, the central features of caring are caring about and taking an overall responsibility for the patient, and teaching the patient to cope with everyday life. Caring is based on practical knowledge, the essential elements of which are intimacy and feelings.

Adaptation, Psychological↗
PubMed1988

Leaving home: the experience of people with a mental handicap.

Open-ended interviews were conducted with 12 people with a mental handicap who had left parental homes in order to live as tenants in community residential hostels. Parents and hostel staff were also interviewed. The nature of life in the family home, and the tenant's role in the move, reasons for leaving home and expectations for the future were explored. It was found that social life, autonomy and opportunities to develop self-help skills had been limited at home. The tenants who had the widest social experience and the greatest use of self-help skills at home were the most active in changing their situation. Tenants hoped to gain more freedom by leaving home, although they were also in agreement with parents and staff about the value of learning new skills.

Activities of Daily Living↗
PubMed1989

Hospital to community: a pilot rehabilitation project for elderly mentally retarded.

Four mentally handicapped patients, three of whom were aged 75 years plus, with a mean age of 67 years (in 1981) and a total institutional life of 160 years, have been successfully rehabilitated in a group home in an active community community environment since August 1981. The process of preparing them for independent living, the social services and community nursing support need, the qualitative change in their life style are described. The success is defined as a fuller community integrated living, free of institutional rigidity and freedom to do what they like with some support and using all the community services as used by other people.

Activities of Daily Living↗
PubMed1989

Overview of a research programme designed to address key issues in the planning and delivery of services for people with mental handicap.

This paper describes the programme of mental handicap research funded by the UK Department of Health, which addresses issues of policy, planning and service delivery of key interest to all involved professionals. The author is manager of the research programme and the research discussed covers the provision of good community residential care, hospital contraction, costs, other services in the community, supporting children with mental handicaps at home with their families, and the special needs of certain groups.

Activities of Daily Living↗
PubMed1990

Moving out: an opportunity for friendship and broadening social horizons?

The study investigated the changes in social activities and social networks of people with mild learning difficulties who moved from family home and from a long-stay hospital to live more independently in the community. Twenty-five people with a learning difficulty, 12 mothers and 33 members of staff participated in this study based on interviews before and after the move to the community. It was found that people with a learning difficulty participated in more community-based activities after the move but they had very few opportunities to meet non-handicapped people. Their segregation remained a main source of dissatisfaction with their social life.

Adult↗
PubMed1990

Psychotropic drugs and mental retardation: 2. A comparison of psychoactive drug use before and after discharge from hospital to community.

The use of psychoactive medication was examined among 64 people with mental retardation who moved from two hospitals to the community as part of a plan of resettlement. There was no significant difference between the overall use of antipsychotic drugs 2 years before discharge, on the date of discharge and after at least 6 months (mean 25 months) of community living, although changes in drugs and doses prescribed had taken place. About 39% of people were receiving antipsychotics, 32% receiving antiepileptics, 7% receiving antidepressants and 8% receiving benzodiazepines.

Adolescent↗
PubMed1990

Evaluation of a community care project for people with learning difficulties.

The quality of life and adaptive behaviour of a group of 17 adults with learning difficulties who transferred from a long-stay hospital or hostel into small community-based group homes was assessed before and 1 year after the move. It was found that the increase in adaptive behaviour was largely dependent on structural staff procedures and there was a bias toward achievement in house-bound skills. Subjects had a low level of community presence and few meaningful relationships. Implications for service planning are discussed.

Activities of Daily Living↗
PubMed1991

Clients' community and social contacts: results of a 5-year longitudinal study.

Clients' contacts with a range of community amenities and with their friends and relatives were examined to assess the impact of a new community-based service. Results over a 5-year period were compared for clients in different residential settings: supported ordinary housing, mental handicap hospital and private family homes. Findings indicated increased use of community amenities for those in supported housing and in their family homes. Little change was noted in clients' contact with relatives, and the paucity of social contact with friends was highlighted. Use of community amenities in relation to the development of social networks is discussed.

Activities of Daily Living↗
PubMed1992

A study of the relationship of community living situation to independence and satisfaction in the lives of mentally retarded adults.

This study examined the relationship between the level of supervision provided at the community residences of 61 adults with mental retardation and their sense of independence and satisfaction in specific aspects of home life, work and community activity. Responses given to interview questions were transformed into scores for independence and satisfaction for each subject. In order to compare the relationship of supervision at home, an individual's intellectual functional ability, and his social support to independence and satisfaction, non-parametric analyses of the data were performed. These revealed statistically significant inverse relationships between the degree of home supervision and independence both at home and within the community, and satisfaction at home. Greater functional ability was found not to be significantly related to any measures of independence or satisfaction. A high level of social support was correlated only with overall measures of community independence, satisfaction at home, and community satisfaction.

Activities of Daily Living↗