View clinical trials related to Long-Term Care.
Filter by:This project will compare two training models of an evidence-based online dementia care training program for direct care staff in assisted living to a waitlist control: 1) essentiALZ training and 2) essentiALZ training + Project ECHO. It will examine the extent to which each model is implemented and achieves its intended outcomes to improve staff knowledge and attitudes, change care practices, and improve the wellbeing of staff, residents, and residents' family members. Results will inform next steps in dementia care training for the assisted living (AL) and broader long-term care workforce. To examine these outcomes, data will be collected from AL staff and families over the course of 6 months. Staff will complete questionnaires and participate in interviews (as applicable) at baseline, post-training, 3-months, and 6-months. Families will participate in interviews at baseline, 3-months, and 6-months.
Background: State Veterans Home nursing homes (SVHs) care for 51% of all Veterans receiving VA-funded nursing home care. SVHs cost VA $1.2 billion yearly in per diem payments. This critical system provides care to a population of over 20,000 vulnerable Veterans annually but has been little researched and is in urgent need of attention. In some SVHs, the COVID-19 pandemic has resulted in large numbers of preventable illnesses, hospitalizations, and even deaths. Congress, the Government Accountability Office, and the Secretary have all called for greater VA involvement in this system that lacks a national quality improvement infrastructure and lags behind VA on many quality measures, including falls. This study addresses SVHs' need to reduce high fall rates-55% of residents experience at least one fall per quarter-by implementing an effective, evidence-based program known as LOCK. In LOCK, staff (1) "Learn from bright spots" (focus on evidence of positive change); (2) "Observe" (collect data through systematic observation); (3) "Collaborate in huddles" (conduct frontline staff huddles); and (4) "Keep it bite-size" (limit activities to 5-15 minutes). The program avoids reliance on existing quality improvement infrastructures, can be easily integrated into frontline staff routines, and has demonstrated success in improving clinical outcomes, including reductions in falls. Significance: This study provides the following. (1) Timely, evidence-based research support to improve care for SVHs' vulnerable population of aging Veterans. (2) Explicit integration of frontline staff expertise, ensuring interventions are practicable and successful. (3) Direct alignment with high-reliability principles-such as sensitivity to operations and deference to expertise-helping extend VA's high-reliability focus to SVHs. Innovation and Impact: This study contributes the following. (1) Advances the science of how to intervene in settings that do not have a strong, centralized quality improvement focus through rigorous investigation of how and why an intervention works in SVHs. (2) Investigates sustainment of the investigators' intervention-the extent to which it becomes part of usual care-for up to 12 months after completion of each step of the investigators' wedge-based design. (3) Provides timely, systematic investigation of a new area for VA research, gathering information on VA researcher-SVH partnerships to support future collaborations. Specific Aims: Aim 1: Investigate the effectiveness of the LOCK program at improving the investigators' primary outcome of any resident fall. This study will also investigate other resident clinical outcomes (mobility, medication changes, restraint and alarm use) and work-process outcomes for staff (job satisfaction, work engagement, burnout). This study will use both primary and secondary data collection. Aim 2: Evaluate the LOCK program's implementation. This study will use the replicating effective programs framework and multi-modal implementation facilitation strategies to implement the program. This study will use mixed methods to evaluate the program's reach, adoption, and implementation. Aim 3: Assess the extent of program sustainment. Mixed methods will enable examination of intervention sustainment at 3, 6, and 12 months post intervention and sustainment variability among sites. Methodology: This is a 4-year hybrid (Type 2) effectiveness-implementation study. It uses a pragmatic stepped-wedge randomized trial design and employs relational coordination theory and the RE-AIM framework to guide implementation and evaluation. Next Steps: This study (1) directly improves care for aging Veterans, (2) advances understanding of how to intervene in settings lacking quality improvement infrastructure, and (3) contributes knowledge about intervention sustainment. This study also addresses VA's Research Lifecycle stages of (a) scale up and spread and (b) sustainment. Findings may help improve care in other settings (e.g., inpatient mental health and domiciliary programs).
Background: In the interventional study of gender mainstreaming, few studies have been conducted on gender empowerment in long-term care. And there are still some limitations in the gender curriculum of current in-service education. This research will cooperate with the digital learning promotion plan to stimulate learners' senses to strengthen their feelings about gender equality issues and events to have a more flexible and diverse learning experience and enhance geriatric care competencies. Purpose: This study is a two-year plan, and the purpose of each year are as follows: 1). To conduct learning needs assessment of long-term care workers, and to develop and construct an educational training module for gender empowerment system of AR interactive experience. 2). To verify the effectiveness of the gender equality knowledge, attitude, awareness, and self-confidence of the research subjects after the "Apply of augmented reality technology" was introduced into the gender curriculum.
Wound infection and bleeding is a risk factor for pressure injury. Calcium alginate silver dressing (CASD) has been shown to be beneficial in a variety of wounds. However, evidence of its benefit in pressure injury(PI) patients in long-term care institutions, especially with respect to Taiwan population, is sparse. This study was to evaluate the effect of CASD and conventional wound dressings on the PI patients in long-term care institutions.
Digital tools can potentially improve the public's reception to and understanding of long-term care information, which will be significantly helpful for long-term care workers and effectively increase the coverage provided by long-term care services. The results of this study could be used to further explore the feasibility of service digitization in the field of long-term care, as well as the integration of technology and professional knowledge to facilitate access to long-term care resources in a modern setting.
Cosmetic therapy provides a psychological effect on the elderly, improving their self-confidence and social participation. This study was conducted to investigate the effectiveness of cosmetic therapy to enhance the self-esteem and reduce depression of elderly residents in long-term care institutions. We expect that a 6-week cosmetic therapy will improve the elderly's mental health, including depression and self-esteem.
When aging, older people migrate to long-term care institutions. The elderly residents lack autonomy due to the characteristics of group life. The decline of health function or the occurrence of diseases can easily lead to reduced physical activity, decreased interpersonal interaction, social withdrawal, low self-esteem, and decreased well-being. In current that emphasizes the elderly in health promotion and disease prevention activities, art therapy can be applied for the elderly to achieve the purpose of health promotion. Art therapy could effectively improve social interaction, self-esteem, and well-being; but many researchers still suggest that it is necessary to investigate the effectiveness of art therapy for elderly residents in long-term care institutions. The purpose of this study is to explore the effectiveness of art therapy in improving social interaction, self-esteem, and well-being for elderly residents in long-term care institutions.
Since the Ministry of Health and Welfare promoted long-term care 2.0 in 2017, it has actively flipped the concept of care. The long-term care professional service added the spirit of self-care, emphasized the dignity and autonomy of the elderly, and provided professional services (including reablement services) to enhance the individual's ability to live independently. However, the use of professional services may be controversial due to unclear understanding of the purpose and service mode of professional services and lack of preparation, vertical (county and city governments, community integrated service centers (A-level units), long-term care service units, etc.) and horizontal cross-professional cooperation is rare, the effectiveness of professional services is unclear, and issues of service quality management also need attention. Therefore, there is an urgent need to integrate the current implementation content and service personnel qualifications of professional services, improve the knowledge of professional service personnel, strengthen the links between county and city governments, A-level units, and long-term care service units, and improve the quality of professional services. The purpose of this plan is to set up experts and working groups, revise the professional service manuals, develop long-term professional service operation guidelines, review the long-term professional service payment system, and develop professional service quality management mechanisms to provide reference for policy planning. Researchers will achieve their goals through the following methods: 1. Establish an interdisciplinary, academic and practical expert working group, professional service manual/operation guide revising group, and hold meetings. Researchers will also review professional service manuals and operational guidelines for the drafts of professional services, and the payment system and the improvement mechanism of service quality, etc. 2. Review domestic and foreign documents: four countries including Norway, the United Kingdom, Australia, and Japan. Researchers will compare the long-term care professional service or reablement service models of various countries, and serve as follow-up experts to revise professional service manuals, operating guidelines, and basis for professional service execution and quality management mode. 3. Achievement analysis of model cases: based on the extended case method of qualitative research, it is expected to solicit high-quality model long-term care professional service units, and in-depth collection of relevant information on the characteristics, process and results of the case homes and service units of successful cases of long-term professional services, conduct ethnographic research and benchmarking, understand the operation of the domestic model, as a follow-up reference for the various tasks of this project . 4. Based on the above-mentioned literature review, model case analysis, expert writing, and multiple meetings, develop a long-term professional service manual/long-term professional service operation guidelines, and propose an amendment draft. 5. Suggestions for the review of the payment system for long-term care professional services: methods include the above-mentioned literature review, establishment of an expert group, case visits, analysis of results of typical cases, and discussions on the draft and different payment methods of various care packages and classification of different payment cases, obtain group consensus through the Delphi method, and conduct pros and cons analysis. 6. Conduct simulation verification for the service payment method draft and different payment case classifications, visit cases (including cases with different disability levels or characteristics), and analyze the verification results and make recommendations for revision. 7. Based on the above literature review, analysis of the results of model cases and discussions at expert meetings, develop professional service quality evaluation and management mechanisms 8. Produce public version of long-term professional service manual/long-term professional service operation guide for lecture notes and educational training media, and handle seven sessions of education training in North, Central, South, and East of Taiwan.
Objective: To assess the feasibility and preliminary effectiveness of an evidence-driven, pragmatic multi-component cognitive intervention with simulated everyday tasks (MCI-SET) with an inclusive group design in community centers Methods: One group, pre-test, post-test, and 3-month follow up research design. The participants who were >=65 and frail, dependence in >= one activity of daily living, or with a confirmed dementia from eight community centers. MCI-SET consisted 12 two-hour weekly group sessions. Feasibility was described with intervention development, fidelity, and acceptability. Outcomes included general daily functioning, general cognition, memory, attention, executive functioning, and processing speed.
This study aims o investigate the effect of a diversified community-based reablement on motor function, cognitive function, performance in activities of daily living (ADL), and physical performance of older people living in remote areas. Older adults who are mobile but unstable were recruited from 6 public elderly day care centers in remote areas of the New Taipei City. Experimental group received a 10-wk diversified community-based reablement service including group exercise, cognitive training, health education for 1.5 hours, and individualized reablement for 1.0 hour, while control group received 1.5-hr group intervention and 1.0-hr placebo intervention. The de Morton Mobility Index (DEMMI), Saint Louis Mental Status Examination (SLUMS), Barthel Index (BI), Canadian Occupational Performance Measure (COPM), and the Short Physical Performance Battery (SPPB) including balance, gait speed, chair stand tests were evaluated twice before and after interventions. The results of the current study are expected to provide evidence in supporting a novel and diversified community-based reablement in remote areas.