Journal of Applied Gerontology

To better understand the process and outcomes of family involvement for long-term care residents with varying stages of dementia, we analyzed family and staff data for 467 residents of 24 residential care/assisted living and nursing-home settings. Adjusted analyses found that although the amount of family visitation did not significantly vary by resident cognitive status (15 versus 20 visits/month to persons with and without dementia, respectively), the nature of the visit did. Families of cognitively intact residents spent more time in activities related to social and community engagement, such as taking residents on trips and calling and writing letters (p < .001), while families of more impaired residents spent more time on care-related activities, including tasks related to nutrition (p < .027), mobility (p = .001), and discussing care with staff (p = .007), the latter of which was associated with greater burden (p < .001). Staff identified similar patterns but perceived less family involvement.

Food and mealtimes play a central role in our lives and often hold great meaning. This study is a secondary analysis of a subset of data collected from a 6-year longitudinal qualitative study called Eating Together (ET), which sought to better understand the experiences around food and mealtimes for community dwelling persons with dementia (PWD) and their primary care partners (CP). Several PWD and, in some cases, their spousal CP, relocated to long-term care (LTC) during the conduct of the ET study. To understand how this relocation influenced the meaning of meals, a subset of those who experienced this transition were selected and analysis specific to this issue was undertaken. Seven families were included in this thematic inductive analysis. Findings revealed five themes related to the different mealtime experience in the LTC home, including systemizing the meal, adjusting to dining with others, holding on to home, evolving mealtime roles, and becoming “at home.” Understanding how families adapt to commensal dining in LTC may be relevant to successful relocation. This work furthers this understanding and provides a basis for person-centered mealtime practices that promote adaptation.

The aim of the study was to examine staff and family members’ perceptions of each other’s roles and responsibilities in the Australian residential aged care setting. Data was collected by interview and focus group from 27 staff and 14 family members at five residential aged care facilities in the state of Victoria, Australia. Findings highlight “communication” as the core category supporting the formation of constructive staff–family relationships, as described by three main themes; “building trust,” “involvement,” and “keeping the family happy.” Staff attitudes, mutual cooperation, meaningful engagement, and shared expectations lay the foundation for relationships. Findings suggest that further efforts to establish and sustain good relationships with families are required by facilities. Characteristics, roles, and expectations of staff and family that can both promote and hinder the formation of constructive staff–family relationships are discussed.

The purpose of this study was to determine: (a) the frequency of family visitation during mealtime and (b) whether the presence of family during meals had an impact on the quality of feeding assistance care and resident intake. Participants included 74 nursing home residents from two Veterans Affairs (VA) and four community facilities in one geographic region. Mealtime periods in which family was present were compared with mealtime periods when family was not present for the same resident. Results showed that family visitation was infrequent during mealtime; however, feeding assistance time was significantly higher when visitors were present. Despite the increase in assistance time, there was not a significant difference in intake. Strategies that encourage the involvement of family in mealtime assistance may have additional benefits not directly associated with meal consumption, including providing family members with meaningful activity during a visit and enhancing residents’ quality of life and well-being.

This research examines how the empowerment of residents’ family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses.

The current study developed prognostic tools to identify dementia caregivers at-risk for clinically relevant burden or depressive symptoms following nursing home admission (NHA) of their family members. A retrospective, longitudinal design was used that included 1,610 dementia caregivers who provided data prior to and up to 6 months following nursing home admission. Response operant characteristic (ROC) curves were constructed to test and validate two prognostic tools: the NHA-Burden and NHA-Depression tools. An ROC curve yielded a sensitivity of 77% and a specificity of 62.5% at a cutoff score of 5.41 for the NHA-Burden Prognostic tool. A second ROC curve indicated a sensitivity of 75.4% and a specificity of 62.5% at a cutoff score of 7.45 for the NHA-Depression tool. Clinicians may wish to utilize cutpoints on the NHA-Burden and NHA-Depression tools to ensure that more persons who are at-risk for clinically significant burden or depression during NHA are identified.