None listed
Conditions
Brief summary
Restorative care to date has focused on physical and daily function but not considered social engagement and quality of life. This highlights the need to develop a restorative care program focusing on quality of life which specifically includes those with cognitive impairment. The significance of this research is that if we show that Lifeful is feasible we will apply for funding to conduct a well-powered randomized controlled trial. This larger trial will add to a growing body of literature on restorative residential aged care, and is timely given the increasing focus of the Australian Aged Care Quality Agency and Department of Health on quality of life. The pilot study aims are to examine: 1. To investigate the feasibility of a delivering and evaluating restorative care program (Lifeful), 2. To investigate staff behavior change and obstacles experienced in adhering to the program 3. To investigate the suitability of the outcome measures. The hypotheses are: 1. It will be feasible to deliver the Lifeful training program to at least 80% of staff working on study units and it will be feasible to recruit at least 80% of residents to participate in the evaluation of the program 2. Care staff will improve engagement with residents as demonstrated by the person-centred assessment tool, as reported in focus groups and through an audit of resident care plans and progress notes. 3. The outcome measures chosen will be suitable i.e. residents can answer the questions, there are no floor or ceiling effects, they capture the changes on outcomes reported by staff in focus groups
Interventions
Staff will be trained to improve the utilization of residents existing care plans and to improve their overall engagement with the residents. The intervention will involve providing all consenting staff 12 hours of training over 12 months (four training sessions of three hours in duration every 3 months). Nurses and recreational activity officers will receive an additional 3 hours of training. Facility management will be supported in making changes to care planning and handover procedures. The
Staff will be trained to improve the utilization of residents existing care plans and to improve their overall engagement with the residents. The intervention will involve providing all consenting staff 12 hours of training over 12 months (four training sessions of three hours in duration every 3 months). Nurses and recreational activity officers will receive an additional 3 hours of training. Facility management will be supported in making changes to care planning and handover procedures. The support will be provided by the chief investigator to problem solve any obstacles or concerns that may arise when changing practice. Training will be offered to all staff in units participating in the pilot study. Facility management will be supported by the chief investigator and research staff in making changes to care planning and handover procedures. The training will be interactive and delivered through a combination of visual presentations, discussions, worksheets, group exercises and role plays. The training sessions will be run by the chief investigator, research assistant or nominated employee of the facility (e.g., clinical nurse educator). All staff will be trained on the following components: (i) the importance of engagement, (ii) improving communication skills, (iii) using resident’s life story as part of their care plans, (iv) care planning as a team, (v) helping elicit resident goals, (vi) having a focus carer for each resident, (vii) understanding how to select and modify activities for people with dementia, (viii) encouraging social engagement and physical activity for residents, (ix) facilitating autonomy, choice and control (x) increasing the status of residents, (xi) increasing incidental exercising, (xii) risk, safety and physical activity, (xiii) incorporating quality of life and engagement conversations during handovers, (xiv) encouraging and enabling more independence through activities of daily living, (xv) sustaining the program Lifeful beyond the year and (xvi) staff self-care. An additional 3-hour training session will be provided to the Recreational Activity Officers with the following content: (i) developing activity plans based on care plans, (ii) having a selection of tailored individual and group activities for residents, (iii) monitoring activity plans for each resident to ensure every resident has engaged in a meaningful activity and (iv) manipulating the environment to encourage engagement in activities. An additional 3-hour training session will be provided to registered nurses where the following content will be covered: (i) clinical leadership – leading care planning teams, (ii) assessing function, utilizing the resident’s strengths, (iii) task analysis for activities of daily living (writing care plans to encourage greater independence), and (iv) incorporating quality of life and engagement conversations during handovers. Descriptive counts will be kept of the training sessions, durations, and topics covered, and staff attendance at training. In addition, there will be a focus group to examine staff experience during the program, including how well they feel the program was adopted and adhered to. There will be tool box sessions to reinforce material presented in the main training sessions and problem solve any obstacles during handover. These sessions will be facilitated by the Clinical Nurse Educator or facility manager. These sessions will be held once between training sessions or staff handovers and will vary from 5 to 15 minutes depending on the other items on the meeting and handover agenda. Toolbox sessions will run for the duration of the intervention (12 months).
Sponsors
University of Sydney
Study design
Allocation
Non-randomised trial
Primary purpose
Treatment
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
The inclusion criteria for residents will be: those who are living in the nominated units. The inclusion criteria for person’s responsible will be: those who are responsible for residents in the nominated units. The inclusion criteria of care staff will be: permanent employees of the nominated units, those who are able to read, write and communicate fluently in English and they consent to participation.
Exclusion criteria
The exclusion criteria of residents will be: withdrawal of consent, death, and relocation away from the residential aged care facility. The exclusion criteria of person’s responsible will be: withdrawal of consent, death or relocation of the resident for whom they are responsible for. The exclusion criteria of care staff will be: withdrawal of consent, cessation of employment at the residential aged care facility.
Outcome results
None listed