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Attitudes of long-term care staff toward dementia and their related factors

Published online by Cambridge University Press:  04 September 2012

Jenny Lee ,
Elsie Hui ,
Carolyn Kng  and
Tung Wai Auyeung
Jenny Lee
Affiliation:
Geriatrics and Medicine Unit, Shatin Hospital, Hong Kong SAR, China Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
Elsie Hui
Affiliation:
Geriatrics and Medicine Unit, Shatin Hospital, Hong Kong SAR, China Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
Carolyn Kng
Affiliation:
Integrated Medical Services, Ruttonjee Hospital, Hong Kong SAR, China
Tung Wai Auyeung*
Affiliation:
Department of Medicine and Geriatrics, Pok Oi Hospital, Yuen Long, Hong Kong SAR, China
*
Correspondence should be addressed to: Dr. Tung Wai Auyeung, Department of Medicine and Geriatrics, Pok Oi Hospital, Yuen Long, New Territories, Hong Kong SAR, China. Phone: +(852) 24868976; Fax: +(852) 24868976. Email: auyeungtw@ha.org.hk.
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Abstract

Background: Attitudes of residential care staff toward residents with dementia affect the quality of care. We examined the attitude of frontline residential care staff toward residents with dementia, and how the presence of specialized care units or programs may affect staff attitude.

Methods: Staff working in nursing homes participated in a survey which covered demographic data, current state of dementia care in workplace, opinion regarding dementia care, and perceived importance of dementia behaviors.

Results: 1,047 nurses and personal care workers participated. 78.8% respondents reported difficulties in managing dementia residents. Those who ranked positive symptoms as more important were 4.5 times more likely to report difficulties, independent of experience. Independent factors associated with positive attitudes toward further training were working in a non-profit home (OR 2.4, 95% CI 1.1, 5.0; p = 0.024) and having a dementia program or unit in the current workplace (OR 1.8, 95% CI 0.985, 3.302; p = 0.056). Only having a dementia program or unit in the current workplace was associated with a positive attitude toward commitment to stay in dementia care (OR 1.9, 95% CI 1.1, 3.2; p = 0.021), adjusted for gender, type of home, post, dementia prevalence in workplace, and work experience.

Conclusion: The majority of long-term care staff felt dementia care difficult yet hold positive attitude toward further training and were committed to stay in dementia care. Having a specialized dementia care unit or program in the current workplace was associated with commitment to stay in dementia care and was marginally associated with positive attitude toward further training.

Keywords

dementianursing homestaff attitudes

Information

Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 1 , January 2013 , pp. 140 - 147
Copyright
Copyright © International Psychogeriatric Association 2012

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References

Aman, E. and Thomas, D. R. (2009). Supervised exercise to reduce agitation in severely cognitively impaired persons. Journal of the American Medical Directors Association, 10, 271–276.CrossRefGoogle ScholarPubMed
Bakker, T. J., Duivenvoorden, H. J., van der Lee, J., Olde Rikkert, M. G., Beekman, A. T. and Ribbe, M. W. (2011). Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial. American Journal of Geriatric Psychiatry, 19, 507–520.CrossRefGoogle ScholarPubMed
Balestreri, L., Grossberg, A. and Grossberg, G. T. (2000). Behavioral and psychological symptoms of dementia as a risk factor for nursing home placement. International Psychogeriatrics, 12 (Suppl. 1), 59–62.CrossRefGoogle Scholar
Bharucha, A. J., Pandav, R., Shen, C., Dodge, H. H. and Ganguli, M. (2004). Predictors of nursing facility admission: a 12-year epidemiological study in the United States. The Journal of the American Geriatrics Society, 52, 434–439.CrossRefGoogle ScholarPubMed
Bonner, A. F., Castle, N. G., Men, A. and Handler, S. M. (2009). Certified nursing assistants’ perceptions of nursing home patient safety culture: is there a relationship to clinical outcomes? Journal of the American Medical Directors Association, 10, 11–20.CrossRefGoogle Scholar
Bostick, J. E., Rantz, M. J., Flesner, M. K. and Riggs, C. J. (2006). Systematic review of studies of staffing and quality in nursing homes. Journal of the American Medical Directors Association, 7, 366–376.CrossRefGoogle ScholarPubMed
Brodaty, H., Draper, B. and Low, L.-F. (2003). Nursing home staff attitudes towards residents with dementia: strain and satisfaction with work. Journal of Advanced Nursing, 44, 583–590.CrossRefGoogle ScholarPubMed
Castle, N. G. and Engberg, J. (2005). Staff turnover and quality of care in nursing homes. Medical Care, 43, 616–626.CrossRefGoogle ScholarPubMed
Census and Statistics Department, The Hong Kong SAR Government (2009). Socio-Demographic Profile, Health Status and Self-Care Capability of Older Persons. Thematic Household Survey Report No. 40. Available at: http://www.statistics.gov.hk/publication/stat_report/social_data/B11302402009XXXXB0100.pdf; last accessed 9 October 2011.Google Scholar
Chau, P. H., Woo, J., Kwok, T., Chan, F., Hui, E. and Chan, K. C. (2010). Usage of community services and domestic helpers predicted institutionalization of elders having functional or cognitive impairments: a 12-month longitudinal study in Hong Kong. Journal of the American Medical Directors Association, 13, 169–175. doi:10.1016/j.jamda.2010.07.011.CrossRefGoogle ScholarPubMed
Chou, K. R., LaMontagne, L. L. and Hepworth, J. T. (1999). Burden experienced by caregivers of relatives with dementia in Taiwan. Nursing Research, 48, 206–214.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J. and Mintzer, J. E. (2005). Time for change: the role of nonpharmacological interventions in treating behavior problems in nursing home residents with dementia. Alzheimer Disease and Associated Disorders, 19, 37–40.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J.et al. (2005). Wisdom from the front lines: clinicians’ descriptions of treating agitation in the nursing home, a pilot study. Journal of the American Medical Directors Association, 6, 257–264.CrossRefGoogle ScholarPubMed
Coogle, C. L., Parham, I. A., Jablonski, R. and Rachel, J. A. (2007). Enhanced care assistant training to address the workforce crisis in home care: changes related to job satisfaction and career commitment. Care Management Journals, 8, 71–81.CrossRefGoogle ScholarPubMed
Cordner, Z., Blass, D. M., Rabins, P. V. and Black, B. S. (2010). Quality of life in nursing home residents with advanced dementia. The Journal of the American Geriatrics Society, 58, 2394–2400.CrossRefGoogle ScholarPubMed
Deudon, A.et al. (2009). Non-pharmacological management of behavioral symptoms in nursing homes. International Journal of Geriatric Psychiatry, 24, 1386–1395.CrossRefGoogle ScholarPubMed
Filipova, A. A. (2011). Relationships among ethical climates, perceived organizational support, and intent-to-leave for licensed nurses in skilled nursing facilities. Journal of Applied Gerontology, 30, 44–66.CrossRefGoogle Scholar
Grant, L. A., Kane, R. A., Potthoff, S. J. and Ryden, M. (1996). Staff training and turnover in Alzheimer special care units: comparisons with non-special care units. Geriatric Nursing, 17, 278–282.CrossRefGoogle ScholarPubMed
Kada, S., Nygaard, H. A., Mukesh, B. N. and Geitung, J. T. (2009). Staff attitudes towards institutionalised dementia residents. Journal of Clinical Nursing, 18, 2383–2392.CrossRefGoogle ScholarPubMed
Kolanowski, A., Litaker, M., Buettner, L., Moeller, J. and Costa, P. T. Jr. (2011). A randomized clinical trial of theory-based activities for the behavioral symptoms of dementia in nursing home residents. The Journal of the American Geriatrics Society, 59, 1032–1041.CrossRefGoogle ScholarPubMed
Lai, C. K., Yeung, J. H., Mok, V. and Chi, I. (2009). Special care units for dementia individuals with behavioral problems. Cochrane Database Systemic Review, CD006470.CrossRefGoogle Scholar
Lee, J. S., Hui, E., Chan, F., Chi, I. and Woo, J. (2008). Associated factors of falls in nursing home residents in Hong Kong and the role of restraints: a cross-sectional survey using the Resident Assessment Instrument (RAI) 2.0. Aging Clinical and Experimental Research, 20, 447–453.CrossRefGoogle Scholar
Liu, D., Hinton, L., Tran, C., Hinton, D. and Barker, J. C. (2008). Reexamining the relationships among dementia, stigma, and aging in immigrant Chinese and Vietnamese family caregivers. Journal of Cross-Cultural Gerontology, 23, 283–299.CrossRefGoogle ScholarPubMed
Macdonald, A. J. and Woods, R. T. (2005). Attitudes to dementia and dementia care held by nursing staff in U.K. “non-EMI” care homes: what difference do they make? International Psychogeriatrics, 17, 383–391.CrossRefGoogle Scholar
Matthews, F. E., Dening, T. and UK Medical Research Council Cognitive Function and Ageing Study (2002). Prevalence of dementia in institutional care. Lancet, 360, 225–226.CrossRefGoogle ScholarPubMed
McCallion, P., Toseland, R. W., Lacey, D. and Banks, S. (1999). Educating nursing assistants to communicate more effectively with nursing home residents with dementia. Gerontologist, 39, 546–558.CrossRefGoogle ScholarPubMed
Mitchell, S. L.et al. (2009). The clinical course of advanced dementia. New England Journal of Medicine, 361, 1529–1538.CrossRefGoogle ScholarPubMed
Mukadam, N., Cooper, C. and Livingston, G. (2011). A systematic review of ethnicity and pathways to care in dementia. International Journal of Geriatric Psychiatry, 26, 12–20.CrossRefGoogle ScholarPubMed
Nihtilä, E. K., Martikainen, P. T., Koskinen, S. V., Reunanen, A. R., Noro, A. M. and Häkkinen, U. T. (2008). Chronic conditions and the risk of long-term institutionalization among older people. European Journal of Public Health, 18, 77–84.CrossRefGoogle ScholarPubMed
Pulsford, D., Duxbury, J. A. and Hadi, M. (2011). A survey of staff attitudes and responses to people with dementia who are aggressive in residential care settings. Journal of Psychiatric and Mental Health Nursing, 18, 97–104.CrossRefGoogle ScholarPubMed
Robison, J. and Pillemer, K. (2007). Job satisfaction and intention to quit among nursing home nursing staff: do special care units make a difference? Journal of Applied Gerontology, 26, 95–112.CrossRefGoogle Scholar
Rozzini, L., Cornali, C., Chilovi, B. V., Ghianda, D., Padovani, A. and Trabucchi, M. (2006). Predictors of institutionalization in demented patients discharged from a rehabilitation unit. Journal of the American Medical Directors Association, 7, 345–349.CrossRefGoogle ScholarPubMed
Seitz, D., Purandare, N. and Conn, D. (2010). Prevalence of psychiatric disorders among older adults in long-term care homes: a systematic review. International Psychogeriatrics, 22, 1025–1039.CrossRefGoogle ScholarPubMed
Simard, J. and Volicer, L. (2010). Effects of Namaste Care on residents who do not benefit from usual activities. American Journal of Alzheimer's Disease and Other Dementias, 25, 46–50.CrossRefGoogle Scholar
van Doorn, C.et al. (2003). Epidemiology of Dementia in Nursing Homes Research Group. Dementia as a risk factor for falls and fall injuries among nursing home residents. The Journal of the American Geriatrics Society, 51, 1213–1218.CrossRefGoogle Scholar
Volicer, L., Simard, J., Pupa, J. H., Medrek, R. and Riordan, M. E. (2006). Effects of continuous activity programming on behavioral symptoms of dementia. Journal of the American Medical Directors Association, 7, 426–431.CrossRefGoogle ScholarPubMed
Wetzels, R. B., Zuidema, S. U., de Jonghe, J. F., Verhey, F. R. and Koopmans, R. T. (2010). Determinants of quality of life in nursing home residents with dementia. Dementia and Geriatric Cognitive Disorders, 29, 189–197.CrossRefGoogle ScholarPubMed
Williams, K. N. and Herman, R. E. (2011). Linking resident behavior to dementia care communication: effects of emotional tone. Behavior Therapy, 42, 42–46.CrossRefGoogle ScholarPubMed
Williams, K. N., Herman, R., Gajewski, B. and Wilson, K. (2009). Elders peak communication: impact on dementia care. American Journal of Alzheimer's Disease and Other Dementias, 24, 11–20.CrossRefGoogle Scholar
Woo, J. and Chau, P. P. (2009). Aging in Hong Kong: the institutional population. Journal of the American Medical Directors Association, 10, 478–485.CrossRefGoogle Scholar
Woo, J., Ho, S. C., Yu, A. L. and Lau, J. (2000). An estimate of long-term care needs and identification of risk factors for institutionalization among Hong Kong Chinese aged 70 years and over. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences, 55, M64–69.Google ScholarPubMed
Zimmerman, S.et al. (2005). Attitudes, stress, and satisfaction of staff who care for residents with dementia. Gerontologist, 45 (Suppl. 1), 96–105.CrossRefGoogle ScholarPubMed