Senior Services – Nursing Homes

Technology is rapidly changing, but the evaluations of ‘Services’ are important areas for the successful delivery model. Take for example, nursing homes or long-term care environments in the Baltimore area were reported for negligence by a local news channel. This is actually quite common as many nursing homes in US were cited for repeated violations of health, safety, and quality care. However, they are still permitted to operate and take in new residents at their facilities (Coalition for Quality Care). Often many facilities fail to create individual care plans for residents or do not permit residents to participate in their own planning.

One article reported 1.5 million nursing facilities in US, and there is a need for interventions that are tied to standardized measurement and quality improvement programs. For example, one of their research studies was conducted among 164 residents at three not-for-profit nursing homes in Pittsburgh, PA area.  The items are organized into 12 domains: comfort, security, food enjoyment, privacy, meaningful activities, religious practices, relationships, functional competence, dignity, individuality, autonomy, and spiritual well-being.

The findings from the research suggest that effective interventions need to be personalized to the individual resident. Facility-wide improvements should not be neglected. However, the best improvements are ones that assist staff to recognize and act on individual residents’ preferences.

A chart referenced by the QOL study.

A chart referenced by the QOL study.

Note: The QOL (Quality of life) care plan related to security focuses on relationships with staff. Each category description: click here.

What about overseas? An article in the New Ergonomics Perspective reported that the available resources for taking care of elderly at home are gradually diminishing in Taiwan. As a result, it presents a considerable change to meet the needs of Taiwan’s ageing society and review the quality of services at nursing homes. In the article, the researchers addressed the importance of identifying resident’s feeling and preferences into the service design specifications.

Nagamachi, a Japanese professor, founded the Kansei Engineering (KE) method that translates customer’s feeling into a design specification and minimizes the subjective interpretation of emotion.

A study using the Kansei Engineering method and Kano model was conducted among 42 elderly from four nursing homes from November 2013 and March 2014. The researchers interviewed each resident for about 30-50 minutes. They residents expected the employees’ dependability and competency. However, the result shows that the three service attributes with the highest requirements are: 1) medical instrument & physical facilities are visually appealing; 2) feel safe and feel at home; 3) quick medical treatment response when patient needs it. On the other hand, the residents do not expect their activities are well scheduled.

The study conducted in US showed their residents’ desire toward security is high. In this case, the security focuses on their relationship with the staff and how well their needs and daily personal cares are provided for. On the other hand, the study conducted in Taiwan concluded that the needs of appealing medical instruments & pristine physical facilities ranked highest among the residents. Depending on the locations and the facilities the residents’ priorities can vary based upon their preferences and needs in their environments. However, both studies state that the elderly should be involved in their daily life planning and how the nursing homes can help them to achieve their desires. Evaluating the service quality of nursing homes or long-term facilities should be done periodically. Technology helps the independence of persons with disabilities or elderly, but its careful monitoring individual’s needs toward the desired outcomes is essential.

Resources:

Improving Quality of life in Nursing Homes

New Ergonomics Perspectives

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