Abstract
Despite the high prevalence of people with dementia living in long-term care (Matthews et al., 2013), studies have persistently shown that many people with dementia living in long-term care have poor quality of life and low levels of wellbeing (Dewitte, Vandenbulcke, & Dezutter, 2019; van der Wolf, van Hooren, Waterink, & Lechner, 2019). This issue of Innovative Practice focuses on different ways of improving service quality in long-term care.
The first article by Villar, Celdrán, Vila-Miravent, and Fernández (2019) explores how people with dementia in long-term care can become more involved in planning meetings about their care. By comparing the quality of life of people with dementia living in care homes in Barcelona who had attended care planning meetings with another group of residents who had not, the authors found that those involved in care planning meetings appeared to experience improvements in their self-determination, social inclusion and overall quality of life.
Participation in meaningful activities is frequently highlighted as essential to improving quality in long-term care settings. However, few staff are given adequate training in how to achieve this. In the second article, Smith, Wood, Jones, Anderson, and Hurley (2019) report on the Active Residents in Care Homes (ARCH) intervention, which was implemented in three care homes in South London. Two occupational therapists, a physiotherapist and a rehabilitation assistant helped staff, residents and relatives to develop individual and group activity plans over the period of a year. Preliminary findings from the study suggested that the ARCH intervention had a positive impact on residents’ wellbeing and but improved staff’s job satisfaction.
An important feature of the ARCH intervention was training staff to use a ‘wellbeing wheel’ which enabled them to assess how all aspects of a resident’s life (such as continence, sleep and medication) were impacting on residents’ engagement in meaningful activities. The final article in this section also reports on the use of a visual assessment tool. The Cognitive Daisy comprises a flower head, consisting of 15 colour coded petals depicting information about: visual spatial perception, comprehension, communication, memory and attention (Hudson & Pollux, 2019). Its primary aim is give staff an ‘at a glance’ indication of the severity of problems within different cognitive domains. This can then be used to adjust interaction with the resident, thereby improving communication, reducing agitation and enhancing person-centred care.
The authors all highlight how their research needs replicating before firm conclusions can be drawn. While each of these Innovative Practice articles illustrates different approaches to undertaking research, they all share the same impetus to improve long-term care for people with dementia.