Canadian journal on aging = La revue canadienne du vieillissement
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ABSTRACTMuch of the literature on health care provider perspectives on medical assistance in dying (MAiD) is focused on the role of the physician, with some literature examining the views of nurses. Some Canadian provinces however, have implemented multidisciplinary approaches to MAiD. ⋯ Key themes emerged across the literature that were related to the complexity of the MAiD process, the importance of relationships and communication, interprofessional roles and dynamics, and the coping process. The results of this review demonstrate the need for further investigation into the experiences of diverse MAiD providers, especially within the Canadian context.
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This study aimed to (1) explore how palliative care in long-term care (LTC) addresses the tensions associated with caring for the living and dying within one care community, and (2) to inform how palliative care practices may be improved to better address the needs of all residents living and dying in LTC as well as those of the families and support staff. This article reports findings from 19 focus groups and 117 participants. Study findings reveal that LTC home staff, resident, and family perspectives of end-of-life comfort applied to those who were actively dying and to their families. Our findings further suggest that eliciting residents' perceptions of end-of-life comfort, sharing information about a fellow resident's death more personally, and ensuring that residents, families, and staff can constructively participate in providing comfort care to dying residents could extend the purview of end-of-life comfort and support expanded integration of palliative principles within LTC.
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Several measuring devices are available to assess specific behavioural problems of dementia patients residing in nursing homes but only a few have been translated and validated in French. This study's main objective was to determine the factorial structure of the French version of the Nursing Home Behavior Problem Scale (NHBPS) with people suffering from dementia. A secondary objective was to document the variables associated with the global score of the NHBPS and the underlying dimensions of the instrument. ⋯ A factor analysis revealed five key dimensions in the francophone version of the questionnaire. Several variables were associated with the total score of the NHBPS and its five underlying dimensions. Although the factorial solution of the French version of the NHBPS is similar to the English versions, our results also show differences that may depend on methodological characteristics.
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Observational Study
Nursing home characteristics associated with resident transfers to emergency departments.
This study examined how nursing home facility ownership and organizational characteristics relate to emergency department (ED) transfer rates. The sample included a retrospective cohort of nursing home residents in the Vancouver Coastal Health region (n = 13,140). Rates of ED transfers were compared between nursing home ownership types. ⋯ Controlling for sex and age, public ownership was associated with lower ED transfer rates compared to for-profit and non-profit ownership. Results showed that higher total direct-care nursing hours per resident day, and presence of allied health staff--disproportionately present in publicly owned facilities--were associated with lower transfer rates. A number of other facility organizational characteristics--unrelated to ownership--were also associated with transfer rates.
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Practitioners are encouraged to consider a shift in their philosophy regarding the manner in which interdisciplinary health care teams ask questions of seniors and their caregivers in the hospital discharge process. By engaging with a discharge framework that encompasses a social-determinants-of-health lens, discharge planning teams can begin to systematically ask questions that move beyond the traditional medical focus on prescriptions, rehabilitation, and treatments. This approach may reveal strengths and also expose health and social inequities that seniors might face upon their arrival home. This information may open a gateway for connecting seniors to social and economic resources that will support them in remaining productive and healthy.