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Evaluation of the Restorative Care Education and Training Program for Nursing Homes*

Published online by Cambridge University Press:  31 March 2010

C. Shanthi Jacob Johnson ,
Anita M. Myers ,
Gareth R. Jones ,
Clara Fitzgerald ,
Darien-Alexis Lazowski ,
Paul Stolee ,
J.B. Orange ,
Nicole Segall  and
Nancy A. Ecclestone
C. Shanthi Jacob Johnson
Affiliation:
Canadian Centre for Activity and Aging School of Nutrition and Dietetics, Acadia University
Anita M. Myers
Affiliation:
Canadian Centre for Activity and Aging Department of Health Studies and Gerontology, University of Waterloo
Gareth R. Jones*
Affiliation:
Canadian Centre for Activity and Aging
Clara Fitzgerald
Affiliation:
Canadian Centre for Activity and Aging
Darien-Alexis Lazowski
Affiliation:
Canadian Centre for Activity and Aging Department of Health Studies and Gerontology, University of Waterloo
Paul Stolee
Affiliation:
Department of Health Studies and Gerontology, University of Waterloo Southwestern Ontario Regional Geriatric Program
J.B. Orange
Affiliation:
Canadian Centre for Activity and Aging School of Communication Science and Disorders, University of Western Ontario
Nicole Segall
Affiliation:
Canadian Centre for Activity and Aging
Nancy A. Ecclestone
Affiliation:
Canadian Centre for Activity and Aging
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être addressées à : Gareth R. Jones, Canadian Centre for Activity and Aging, University of Western Ontario, London, ON, Canada. ([email protected]), www.ccaa-outreach.com, www.uwo.ca/actage
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Abstract

Restorative care attempts to break the cycle of dependency and functional decline in nursing homes by addressing individual resident needs. The Restorative Care Education and Training (RCET) Program consists of a five-week workshop and resource manual for both supervisory and direct care staff. This paper describes the RCET approach and presents the implementation, process, and quasi-experimental outcome evaluation findings with 42 residents from six intervention sites and six “wait-list” facilities who received usual care. Baseline data supported the fact that staff primarily targeted residents with substantial functional impairments. Over four months, residents who received restorative care improved significantly on several functional outcome indicators, while the comparison sample declined in several areas of functioning. Interviews with facility directors and participating staff provided direction for modifying the RCET and insight regarding opportunities and challenges when implementing restorative care activities in nursing homes.

Résumé

Les soins de rétablissement visent à rompre le cycle de la dépendance et du déclin fonctionnel dans les maisons de soins infirmiers en répondant aux besoins particuliers des divers résidents. Le programme RCET (Restorative Care Education and Training) comprend un atelier de cinq semaines ainsi qu'un manuel d'information destiné autant aux superviseurs qu'aux prestataires de soins directs. Ce document décrit l'approche du programme RCET et présente la mise en oeuvre, les procédés et les résultats d'une évaluation quasi-expérimentale portant sur 42 résidents qui ont reçu des soins réguliers dans six lieux d'intervention différents et six établissements de « liste d'attente ». Les données de base ont permis de confirmer que le personnel mettait surtout l'accent sur les résidents qui souffraient de handicaps fonctionnels substantiels. En quatre mois, les résidents qui ont reçu des soins de rétablissement ont vu plusieurs de leurs indicateurs relatifs aux résultats fonctionnels s'améliorer de façon considérable, tandis que dans le groupe de contrôle, les sujets voyaient plusieurs de leurs fonctions décliner. Les entrevues menées auprès de la direction de l'établissement et du personnel ayant participé à l'étude ont permis de dégager certaines orientations visant à modifier le programme RCET, ainsi que certaines perspectives relatives aux possibilités et aux défis à relever afin de mettre en oeuvre des activités de soins de rétablissement dans des maisons de soins infirmiers.

Keywords

restorative carenursing homesagingsoins de rétablissementcentre de soins infirmiers
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 24 , Issue 2 , Summer/Été 2005 , pp. 115 - 126
Copyright
Copyright © Canadian Association on Gerontology 2005

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Footnotes

*

This work was supported by the Ministry of Health, Long-term Care Division. This work has been reported, in part, at annual meetings of the Canadian Association of Gerontology and the Gerontology Society of America. The contributions of the Southwestern Ontario Regional Geriatric Program, the Alzheimer's Society of London and Middlesex, Fanshaw College, the project steering committee, and all the administrators, staff, and residents who took part are gratefully acknowledged.

References

Atchinson, D. (1992). Restorative nursing: A concept whose time has come. Nursing Homes, 41(1), 9–12.Google Scholar
Baker, D.I., Gottschalk, M., Eng, C., Weber, S., & Tinetti, M.E. (2001). The design and implementation of a restorative care model for home care. Gerontologist, 41(2), 257–263.CrossRefGoogle ScholarPubMed
Baltes, M., Neuman, E., & Zank, S. (1994). Maintenance and rehabilitation of independence in old age: An intervention program for staff. Psychology and Aging, 9, 179–188.CrossRefGoogle ScholarPubMed
Baum, E.E., Jarjoura, D., Polen, A.E., Faur, D., & Rutecki, G. (2003). Effectiveness of a group exercise program in a long-term care facility: A randomized pilot trial. Journal of American Medical Directors Association, 4, 74–80.CrossRefGoogle Scholar
Blocker, W.P. (1992). Maintaining functional independence by mobilizing the aged. Geriatrics, 47, 42–56.Google ScholarPubMed
Cohen, J. (1977). Statistical power analysis for the behavioral sciences. New York: Academic Press.Google Scholar
Coleman, B. (1991). The Nursing Home Reform Act of 1987: Provisions, policies, prospects. Boston: University of Massachusetts Gerontological Institute.Google Scholar
Foy, S., & Mitchell, M. (1990). Factors contributing to learned helplessness in the institutionalized aged: A literature review. Binghamton, NY: Haworth Press Inc.Google Scholar
Gordon, J., Powell, C., & Rockwood, K. (1999). Goal attainment scaling as a measure of clinically important change in nursing home patients. Age and Ageing, 28, 275–281.CrossRefGoogle ScholarPubMed
Granger, C., & Hamilton, B. (1993). The uniform data system for medical rehabilitation report of first admissions for 1991. American Journal of Physical Medicine and Rehabilitation, 72(1), 33–38.CrossRefGoogle ScholarPubMed
Helmes, E., Csapo, K., & Short, J. (1987). Standardization and validation of the multidimensional observation scale for elderly subjects (MOSES). Journal of Gerontology, 42, 395–405.CrossRefGoogle ScholarPubMed
Joseph, C., & Wanlass, W. (1993). Rehabilitation in the nursing home. Clinics in Geriatric Medicine, 9(4), 859–871.CrossRefGoogle ScholarPubMed
Kazis, L., Anderson, J., & Meenan, R. (1989). Effect sizes for interpreting changes in health status. Medical Care, 27, 178–189.CrossRefGoogle ScholarPubMed
Lazowski, D., Ecclestone, N., Myers, A., Paterson, D., Tudor-Locke, C., Fitzgerald, C. Jones, G., Shima, N., & Cunningham, D.A. (1999). A randomized outcome evaluation of group exercise programs in long-term care institutions. Journal of Gerontology: Medical Sciences, 54(12), M621–M628.Google ScholarPubMed
Lord, S., Lloyd, D., Nirui, M., Raymond, J., Williams, P., & Stewart, R. (1996). The effect of exercise gait patterns in older women: A randomized trial. Journal of Gerontology, 51A, M64–M70.Google Scholar
MacKnight, C., & Rockwood, K. (1995). A hierarchical assessment of balance and mobility. Age and Ageing, 24, 126–130.CrossRefGoogle ScholarPubMed
MacRae, P.G., Asplund, L., Schnelle, J., Ouslander, J., Abrahamse, A., & Morris, C. (1996). A walking program for nursing home residents: Effects on walk endurance, physical activity, mobility, and quality of life. Journal of the American Geriatrics Society, 44(2), 175–180.CrossRefGoogle ScholarPubMed
MacRae, P.G., Schnelle, J.F., Simmons, S.F., & Ouslander, J.G. (1996). Physical activity levels of ambulatory nursing home residents. Journal of Aging and Physical Activity, 4, 264–278.CrossRefGoogle Scholar
Morris, J.N., Fiatarone, M., Kiely, D.K., Belleville-Taylor, P., Murphy, K., Littlehale, S., Ooi, W.L., O'Neill, E.O., & Doyle, N. (1999). Nursing rehabilitation and exercise strategies. Journal of Gerontology: Medical Sciences, 54(10), M494–M500.Google ScholarPubMed
Myers, A.M. (1999). Program evaluation for exercise leaders. Champaign, IL: Human Kinetics.Google Scholar
Myers, A.M., & Huddy, L. (1985). Evaluating the physical capabilities of the elderly: The relationship between ADL self-assessments and basic abilities. Canadian Journal on Aging, 4, 189–200.CrossRefGoogle Scholar
Norman, G., & Gibbs, J. (1991). Why walk when you can ride? Clinical ambulation incentives for the immobile elderly. Journal of Gerontological Nursing, 17, 28–33.CrossRefGoogle ScholarPubMed
Nowalk, M.P., Prendergast, J.M., Bayles, C.M., D'Amico, F.J., & Colvin, G.C. (2001). A randomized trial of exercise programs among older individuals living in two long-term care facilities: The FallsFREE program. Journal of American Geriatrics Society, 49, 859–865.CrossRefGoogle ScholarPubMed
Pawlson, L.G., Goodwin, M., & Keith, K. (1986). Wheelchair use by ambulatory nursing home residents. Journal of the American Geriatrics Society, 34, 860–864.CrossRefGoogle ScholarPubMed
Podsialdo, D., & Richardson, S. (1991). The timed “up and go”: A test of basic functional mobility for frail elderly persons. Journal of Geriatrics Society, 39(2), 142–148.Google Scholar
Remsburg, R.D., Armacost, K.A., Radu, C., & Bennett, R.G. (1999). Two models of restorative care in the nursing home: Designated versus integrated restorative nursing home assistants. Geriatric Nursing, 20(6), 321–326.Google Scholar
Resnick, B., & Fleishell, A. (2002). Developing a restorative care program: A five-step approach that involves the resident. American Journal of Nursing, 102(7), 91–95.CrossRefGoogle Scholar
Resnick, B., & Simpson, M. (2003). Restorative care nursing activities: Pilot testing self-efficacy and outcome expectation measures. Geriatric Nursing, 24(2), 82–89.CrossRefGoogle ScholarPubMed
Santo Pietro, M. (1994). Assessing the communicative style of caregivers of residents with Alzheimer's disease. Seminars in Speech and Language, 15(3), 236–254.CrossRefGoogle Scholar
Schnelle, J., Cruise, P., Rahman, A., & Ouslander, J. (1998). Developing rehabilitative behavioral interventions for long-term care: Technology transfer, acceptance, and maintenance issues. Journal of the American Geriatrics Society, 46(6), 771–777.CrossRefGoogle ScholarPubMed
Schnelle, J.F., MacRae, P.G., Ouslander, J.G., Simmons, S.F., & Nitta, M. (1995). Functional incidence training, mobility, performance, and incontinence care with nursing home residents. Journal of the American Geriatrics Society, 43, 1356–1362.CrossRefGoogle Scholar
Sidani, S., Epstein, D.R., & Moritz, P. (2003). An alternate paradigm for clinical nursing research: An exemplar. Research in Nursing and Health, 26, 244–255.CrossRefGoogle ScholarPubMed
Stolee, P., Stadnyk, K., Myers, A.M., & Rockwood, K. (1999). An individualized approach to outcome measurement in geriatric rehabilitation. Journal of Gerontology: Medical Sciences, 54, M641–M647.Google ScholarPubMed
Stolee, P., Zaza, C., Pedlar, A., & Myers, A.M. (1999). Clinical experience with goal attainment scaling in geriatric care. Journal of Aging and Health, 11(1), 96–124.CrossRefGoogle ScholarPubMed
Tinetti, M.E., & Ginter, S.F. (1990). The Nursing Home Life-Space Diameter: A measure of extent and frequency of mobility in nursing home residents. Journal of the American Geriatric Society, 38, 1311–1315.CrossRefGoogle ScholarPubMed
Tinetti, M.E., Baker, D., Gallo, W.T., Nanda, A., Charpentier, P., & O'Leary, J. (2002). Evaluation of restorative care vs usual care for older adults receiving an acute episode of home care. Journal of the American Medical Association, 287(16), 2098–2105.CrossRefGoogle ScholarPubMed