Farida K. Ejaz

Falls Among Nursing Home Residents: An Examination of Incident Reports Before and After Restraint Reduction Programs

OBJECTIVE: To examine changes in the rate of falling of an experimental group of restrained subjects who underwent restraint reduction, and to compare their rate of falling with a group of subjects who did not have restraint orders during the study period.

Family Satisfaction With Nursing Home Care for Relatives With Dementia

Families of residents with dementia from five nursing homes were interviewed to assess if they believed improvements were needed in the care provided to their relatives. Quality of care was assessed in a variety of service and staff areas that factored into two domains of care: (a) environmental and administrative services and (b) direct care. Families who perceived significant improvements were needed in environmental and administrative services had more negative interactions with staff, perceived nurse assistants as being insensitive, and helped relatives with more activities of daily living (ADL). With respect to direct care, families perceived significant improvements were needed when they had more negative interactions with staff and helped their relatives with more ADL. These findings highlight the importance of promoting positive familystaff interactions, providing direct care in a sensitive manner, and exploring the reasons why families get involved in ADLto improve family satisfaction with care.

Developing and testing a satisfaction survey for nursing home residents: the Ohio Experience.

Abstract Input from consumers has become an important part of quality improvement in long-term care and for consumer decision-making. This paper documents the development of the Ohio Nursing Home Resident Satisfaction Survey (ONHRSS) through a partnership of state government, research, and industry experts. The instrument was tested and refined through two waves of data—a pretest phase and later with statewide data. Exploratory and confirmatory analyses with statewide data identified eight primary factors along with an underlying, secondary Global Satisfaction factor. Reliability of the domains ranged from .69 to .95. Recommendations for further refinement and testing of the instrument are discussed along with policy and practice implications.

Resident Satisfaction with Long-Term Care Services

(2007). Resident Satisfaction with Long-Term Care Services. Journal of Aging & Social Policy: Vol. 19, No. 2, pp. 1-8.

Impact of family members on nurse assistants: What helps, what hurts

This qualitative study focuses on nurse assistant reports of both positive and negative behaviors exhibited by family members of cognitively impaired residents. The information reported is obtained from in-person interviews with 114 nurse assistants in 5 skilled nursing facilities (3 philanthropic, 2 proprietary) in Greater Cleveland, Ohio. Nurse assistants were predominantly female (89 percent), white (60 percent), with a mean age of 33, and had been caring for cognitively impaired nursing home residents for an average of five years. Content analyses of nurse assistants’ responses reveal five categories of family members’ positive behaviors and four categories of negative behaviors. This article focuses on these themes and suggests topics for educational interventions for family members and nurse assistants who care for cognitively impaired nursing home residents. Topics include coping with family members’ feelings of guilt and related behaviors, understanding longstanding family relationship issues, and understanding possible reasons for decisions family members make regarding care of their relatives.

Examining direct service worker turnover in three long-term care industries in Ohio.

This is the first study to examine direct service worker turnover and its predictors across three provider types: nursing homes, home health agencies, and providers of services for the developmentally disabled. Stratified random sampling procedures were used to select provider types across five geographic regions in Ohio. Data were collected from administrative staff. Findings indicated that annual direct service worker turnover did not significantly vary by provider type (mean = 33%). Predictors of turnover related to job burnout, negative social support, and region. Policymakers can promote practices to lower direct service worker turnover such as addressing burnout and increasing support.

Next Steps: Documentation and Accessing Community Healthcare Resources

Documentation by healthcare professionals is critical in the clinical management of elder abuse, particularly focused on financial exploitation. This chapter discusses the importance of documentation for prevention and resolution, highlighting key qualities of effective documentation and suggestions for how to record the information. It considers the usefulness of screening tools for problem detection, assessment, and resource identification. It also includes examples of a few tools to assess financial exploitation along with the more generic elder abuse tools developed by the chapter authors and their adaptation to focus on financial exploitation. Finally, the chapter concludes by considering community resources that are likely to be useful to healthcare professionals, barriers to access, and suggestions for overcoming barriers when financial exploitation is one of the forms of abuse being investigated.