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doi: 10.1111/j.1365-2702.1997.tb00339.xpmid: N/A
Summary • This article considers the nurse's role in assisting family (informal) carers who adopt their role suddenly, following an acute health crisis. Carers of stroke survivors are used as a ‘paradigm’ case to highlight the challenges faced by family members at the time of hospital discharge. • The needs of family members who suddenly adopt a caring role are poorly understood, but greater awareness is needed as the Carers (Recognition and Services) Act (1995) provides statutory recognition of the rights of such individuals to an assessment of their needs, emphasizing the importance of carers making an informed choice based on a willingness and ability to adopt a care‐giving role. • Evidence suggests that new family carers are currently poorly prepared to take on their role, lacking the information and skills needed to provide good care. Nurses have a major role to play in preparing carers, but currently lack a systematic approach to assessment and intervention. • Further empirical work is required to establish more clearly the needs of new carers and to develop and evaluate appropriate intervention strategies to address their needs.
doi: 10.1111/j.1365-2702.1997.tb00340.xpmid: N/A
Summary • Discharge of older people from hospital has been an area of concern for over 20 years. • The present emphasis on rapid throughput of patients in acute care settings is likely to exacerbate existing problems. • Improving current practice will mean addressing a number of complex issues to do with communication between agencies and professions. • Despite different welfare systems, many of the challenges of discharge planning are shared in different countries. • This paper describes attempts to involve patients and carers in discharge planning in Sweden and the UK and identifies a number of areas which require attention if the ideals of patient and carer empowerment are to be achieved.
DELLASEGA, CHERYL; NOLAN, MIKE
doi: 10.1111/j.1365-2702.1997.tb00341.xpmid: N/A
Summary • Admission to care after a period of family care‐giving has been the focus of much recent research. • Rather than being seen as an end in itself, admission is part of a process. • This article concentrates on ‘reaching the end’ of family care‐giving and the ‘new beginning’ of entering residential care. • A cross‐national study conducted in the USA and the UK is discussed, and similarities and differences in the two cultures are highlighted. • Decisions to enter a nursing home were often taken hurriedly and with lack of information in both countries. • Issues of quality of care and emotional responses by former carers were also important in both settings.
MITCHELL, PATRICIA; KOCH, TINA
doi: 10.1111/j.1365-2702.1997.tb00342.xpmid: N/A
Summary • Advanced frailty and confusion of many nursing home residents present a particular conundrum to researchers committed to resident participation. While the research is set in Australia, the challenge of frailty is common to researchers working with compromised older persons. • This study was conducted in an Australian 32 bed nursing home. As researchers we took on the roles of facilitators and negotiators within a quality improvement process using the approach of fourth generation evaluation. • The overall aim of the project was to provide all stakeholders, including residents and their significant others, with a voice in the negotiations and decisions that impact on their lives. • The focus of this paper is our attempt to gain the perspective of residents and significant others.
MORGAN, DEBRA; REED, JAN; PALMER, ANTHONY
doi: 10.1111/j.1365-2702.1997.tb00343.xpmid: N/A
Summary • Discharge planning has received much attention in the nursing literature over the past few years, and there has been particular concern over the discharge of older people back into their domestic environment. • The practical and logistical problems of managing such a discharge are considerable, but in this paper we argue that discharging older people from hospital to care homes is equally problematic, though in different ways. • This is a neglected area of research, perhaps because discharge into a care home seems to present fewer organizational problems. • There is, however, an extensive body of literature from a range of different disciplines which suggests that the loss of home and entry into a strange environment can be very stressful. • This paper outlines this literature and explores the implications for nursing practice.
ROSS, MARGARET M.; ROSENTHAL, CAROLYN J.; DAWSON, PAMELA
doi: 10.1111/j.1365-2702.1997.tb00344.xpmid: N/A
Summary • The purpose of this study was to investigate the visiting experience of wives whose husbands had been admitted to a long‐term care institution. • The study employed a longitudinal and prospective design and combined qualitative and quantitative approaches. • The data were drawn from a larger study designed to explore the transition to quasi‐widowhood. • This article reports on one aspect of spousal caregiving following the admission of a husband to a long‐term care setting, i.e. visiting. • In this study, wives visited frequently. Their reasons for visiting included love and devotion, duty and obligation, the monitoring of husbands' well‐being and the provision of assistance to both husbands and staff. They engaged in task performance and social interaction during visiting. Their feelings of satisfaction and enjoyment with visiting were associated with their husbands' well‐being and feeling useful. • Over the 9‐month period of the study, two patterns of visiting and involvement emerged that were associated with different outcomes related to depression, morale and satisfaction with institutional dimensions of care.
WATKINS, MARY; REDFERN, SALLY J.
doi: 10.1111/j.1365-2702.1997.tb00345.xpmid: N/A
Summary • A new night hospital nursing service was developed for older people with dementia. • A case study approach to evaluation was adopted using a structure‐process‐outcome quality assurance cycle. • The effects and attendance of patients are reported and discussed. • Discussion relating to care provision for the future is presented. • The effects on carers of patients' attendance are briefly discussed.
RULAND, CORNELIA M.; KRESEVIC, DENISE; LORENSEN, MARGARETHE
doi: 10.1111/j.1365-2702.1997.tb00346.xpmid: N/A
Summary • The refinement of a patient assessment tool for older patients, Lorensen's Self‐Care Capability Scale, is described where a systematic elicitation of patient preferences is included in the assessment. • This study tests a decision analytic approach as a strategy for formalizing subjective judgement, which makes it possible to include patients' own values and preferences in planning patient care. • Applying this technique to patient assessment contributes to explicitly tailoring nursing care decisions to desired outcomes as preferred by individual patients. • A shared approach to decision making between nurse and patient ensures a mutual understanding about goals, priorities and patient values through discussion and negotiation. • This pilot study supported the merit of including patient preferences systematically in the assessment of older patients. • The method provides an important decision aid for nurses in planning nursing care in accordance with patients' own values and preferences for care.
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