“Would You Do That in Your Home?” Making Nursing Homes Home-like in Culture Change Implementation

Qualitative interviews with nursing home administrators reveal innovative and cost-conscious ways to physically modify facilities that help institute culture change practices. Telephone interviews were conducted following a national survey of nursing home nursing directors and administrators. In this cross-sectional snapshot of administrator experiences, motivations for making facilities more home-like and less institutional and creative responses to challenges are described. State and corporate support and regulator encouragement are noted that help their reform efforts. Administrators note that small steps to create a more home-like environment can result in a positive impact that minimizes disruption to existing care processes. They describe how they respond to challenges, such as the physical plant and high costs, and note how comparative shopping, cost-conscious physical improvements, and continuous involvement of staff and residents contribute to successful efforts. Their examples illustrate novel ways to humanize long-term care facilities that other nursing homes can emulate.     

Conflict and Aggression as Stressors in the Work Environment of Nursing Assistants:

Elder abuse and mistreatment occuring in institutional settings is a phenomenon that is as yet poorly understood. In considering the context in which elder abuse and mistreatment may arise, understanding the caregivers' work environment is an important variable. As front line staff, nursing assistants are subject to multiple stressors that underscore the highly interpersonal nature of caregiving. This paper describes the results of a Canadian study that examined conflict, aggression, and burn-out in one group of nursing assistants. Nursing assistant burn-out scores were similar to scores reported for other health-care workers. Subjects reported that conflict with residents most commonly related to the resident wanting to go outside the facility or personal hygiene. An analysis of incident reports indicated that less than 0.3% of the physical and verbal aggression nursing assistants endure from residents is formally acknowledged. On average, a nursing assistant in this health care facility may expect to be physically assaulted by residents 9.3 times per month and verbally assaulted 11.3 times per month. Findings indicate a slight correlation between burn-out and conflict and also between burn-out and reported aggression from residents. A statistically significant relationship was noted between conflicts with residents and resident aggression from residents.     

Autonomy and Control in Everyday Life in Care of Older People in Nursing Homes

Self-control and autonomy are not guaranteed when people age and are in need of help from others, especially in institution-based housing. This occurs despite the fact that it is a generally accepted belief that care should be delivered with the greatest possible degree of independence and autonomy. This article discusses older people's experiences with and the opportunities for autonomy in institution-based housing. Through focus group interviews and observations, the daily lives of residents at two nursing homes in Sweden were studied through a comparative approach using the theoretical framework of organizational culture. Three themes emerged showing how autonomy was not a reality for the residents. The first theme revealed an ambivalent mission, indicating ambiguity as to whether the nursing home was a place to live in or a place in which to be cared for. The second theme was symbolic power, which encompassed the staff's power embedded in the organization. The third theme was the ageist approach to care, which was noted in the way staff considered the residents to be old people who were unable and unwilling to strive for autonomy. The three themes were embedded in the organizational culture and were created and recreated in the interaction between residents and staff. A key question for further research is how to change the culture to strengthen the residents’ autonomy.     

Nursing home satisfaction,biography, and the life worlds of psychiatrically disabled residents

The stereotype of nursing home life as a uniformly dismal experience is pervasive in American culture, but this examination of the attitudes of psychiatrically disabled residents calls this generality into question. Residents in this study exemplified a range of opinions about the nursing home — some were clearly satisfied or dissatisfied, but most were ambivalent. In this paper, I explore the relationship between nursing home satisfaction and individual interpretive activity through the biographies of three residents. I find that how residents made sense of their lives was powerfully linked to their perspectives on nursing home residence. In particular, satisfaction was linked to how each resident viewed his or her illness, institutionalization, and life purpose. Understanding the phenomenological contributors to the meaning of nursing home life is essential to appreciating how it is that residents in the same environment can have vastly different outlooks on their surroundings.     

Family Members' Reports of Non-Staff Abuse in Michigan Nursing Homes

Recent research showed that mistreatment of nursing home residents by other residents may be highly prevalent. The present study examined the issue from family members' perspectives. The data came from the 2005 and 2007 random-digit dial telephone surveys of Michigan households with a family member in long-term care. Based on family members' reports, about 10% of nursing home residents aged 60 and over were abused by non-staff in nursing homes (e.g., other residents and visitors) during the past 12 months. Family members were more likely to report non-staff abuse when the nursing home residents were younger, were female, had behavior problems, and had greater level of physical functioning. Family members who reported staff abuse were four times more likely to also report non-staff abuse.     

创新工作理念真情服务妇女——专访四川省妇联主席吴旭

1970年出生的吴旭，是个土生土长的“川妹子”，她对家乡以及这片土地上的妇女姐妹有着深厚的感情。在她看来，四川是中国国情的一个缩影，多民族、地域辽阔、地理复杂，且全省4500多万妇女60％左右在农村，造成妇女需求多元化、妇女工作点多面广，挑战极大。她希望可以借鉴各国在管理和服务妇女方面的工作经验，努力建设服务型、学习型的妇联组织，为发展当地妇女事业争取更大的空间。     

“It’s a Dignity Thing”: Nursing Home Care Workers’ Use of Emotions1

This article examines how nursing home care workers use emotions to construct dignity at work. Previous scholarship has shown how the financial and organizational characteristics of nursing homes shape and constrain emotion work among staff. Using evidence gathered during 18 months of participant observation in two nursing homes and 65 interviews with staff, this article analyzes how, despite obstacles, nursing home care workers generated authentic emotional attachments to residents. Surprisingly, some staff members said they particularly appreciated working with residents difficult to control. They felt accomplished when such residents successfully transitioned from life at home to life in institutional care. Emotions created dignity for staff and induced compliance among residents. Emotions are not only generated by organizations and imposed on workers; staff themselves produced emotions—sometimes in ways consistent with organizational demands, and sometimes not—and they consistently found in their emotions a resource to manage the strains of their work lives.     

Job satisfaction among nurse assistants employed in nursing homes: An analysis of selected job characteristics

The quality of life of residents of nursing homes depends heavily upon the work of nurse assistants (also known as nurse aides). However, beyond basic demographic data, little is currently known about this highly important category of care providers. This study explores the relationships between selected job characteristics and job satisfaction of 138 nurse assistants employed in nursing homes in Ohio. Factor analyses reveal four dimensions among these job characteristics. These dimension are labeled supervision, personal recognition, family/ work conflict, and qualifications. Only qualifications fail to show a significant correlation with the nurse assistants' levels of job satisfaction. The strongest relationship is with supervision. The implications of the findings for job satisfaction and job performance among nurse assistants are discussed.     

Jumping On and Off the Runaway Train of Success: Stress and Committed Intensity in an Academic Life

This story describes a seasoned professor's attempts to take stock of her academic life. The main voice is that of the professor as she lives, works, and considers what she cares about. The cacophony of other sounds comes from the questioning voices inside her head, blended with the imagined voices of her dogs Zen and Buddha, and the real voices of colleagues and her partner, Art. The author examines the ups and downs of her academic life and how stress, interruption, caring, and committed intensity play out. She provides her story as a mindful revision of how she wants to live and to stimulate readers to reflect on their own lives.     

Deutsch-polnisches Training: Persönliche und professionelle Erfahrungen mit Bikulturalität und Interkulturalität – Anspruch und Wirklichkeit

This report contains several experiences and authentic examples taken from highly professional German-Polish and Polish-German coaching groups. Accordingly, ideas are in part presented from a very personal point of view. Running “Intercultural activities” is very much praised in a world that becomes more and more globalized. But how do these activities work out in practice? The author’s goal is to explain the cultural differences in order for managers to be able to work effectively in international projects. The author illustrates her method and her goals by giving characteristic examples. She talks about demands as far as the personality of the coach is concerned, as well as about interferences within the coaching situation. A prevailing common culture in Europe does not (yet) exist which makes it even more important to talk about differences openly so that they can be understood and be overcome. Useful experiences are shared which shall help to build a ‘working’ trust level between representatives of different cultures. Cultural factors of power usage are described which show how power can be applied in different ways. The influence of language problems is also analyzed in detail. Finally, this paper shows that the most important is to keep an atmosphere based on cooperation: only when such an atmosphere is accepted as a natural daily routine can contacts among participants of different cultures be established as among equals and it is then possible to overcome the challenges related to differences of cultures.     

Old Dreams,New Means: an Exploration of Visions and Situated Knowledge in Information Technology

The aim of this article is to explore the tensions and ambivalences of new and old technology and political visions of keeping viable, quality care and services for elderly citizens through the use of new information technologies. The visions of politicians and social service managers of keeping alive the welfare state and retaining its ability to offer quality care and services for elderly citizens are compared with the experiences of female care assistants and their expectations of technology. A feminist figure — the cyborg — will be used in this exploration. We consider how care assistants are integrated in networks of socio‐technical relations between humans and non‐humans, and the extent to which gender or asymmetrical power relations between women and men intervene in their stories.     

Developing programs for older adults in a faith community

I have worked in all areas of nursing, from staff and head nurse positions to faculty and administrative positions, but my work as a parish nurse, particularly with our community of older adults, is one of the most challenging and rewarding areas of nursing practice I have ever experienced. Recently, one of our independent older adult parishioners, Marge, suddenly had a marked decrease in her ability to function, which was precipitated by two trips to the hospital and surgery. She went from living independently to living in a skilled care unit, no longer able to walk or perform activities of daily living without assistance. I had known Marge for only 2 years. When she became ill, I visited her weekly during the last 4 months of her life, as she had no family in the area. During my visit one evening as I helped Marge get ready for bed, she left me with a very poignant memory. After sharing some hair-raising stories about her care at this facility, she said, "Georgine, you're my best friend. You're the only one I can tell these things to and I know you understand."     

Being Transgender and Older

Summary

Tina Donovan conveys her first person account of living as a transgender person and coming of age in the 1950s and 60s. She tells the story of her particularly negative experiences looking for employment and housing, and obtaining medical care. The account focuses on the implications of the lack of financial security as transgender persons who have been prohibited from attaining legitimate work began to reach old age. It also chronicles the abuses and neglect within the medical establishment as one attempts to get assistance for psychological and physical ailments. The author also shows how crucial LGBT organizations and support groups can be to transgender survival.     

Fingers,Flexors and Flaps: Impressions of a Hand Unit Social Worker

This paper examines the first six months the author spent as social worker in the Hand Unit, Sydney Hospital. She describes her introduction to the Unit, how she set about learning a completely new area of expertise and offers some case examples. She discovers that because the hand is so crucial to our self perception, damage to it cannot be taken lightly. Further, hand injuries can often mask much deeper emotional injuries that must be treated. The social work role in the Hand Unit is as diverse as it is important.     

Mental Disorders Among Non-Elderly Nursing Home Residents

Many Medicaid beneficiaries aged 22 to 64 with serious mental illness may be admitted to nursing facilities rather than psychiatric facilities as a result of Medicaid policies prohibiting coverage of inpatient psychiatric care in institutions of mental disease while requiring states to cover nursing facility care. Using nationwide Medicaid Analytic Extract claims from 2002, we found that nearly 16% of nursing home residents aged 22 to 64 had a diagnosed mental disorder, while 45.5% received antipsychotic medication, but these rates varied widely across states. Further research is necessary to determine whether, among the nation's youngest nursing home residents, care in nursing homes is potentially substituting for care in institutions for mental disease or community-based settings.     

Nursing a Grievance? The Role of Healthcare Assistants in a Modernized National Health Service

The complex division of labour in health care has encouraged the analysis of occupational boundary disputes between separate professions. Less attention has been directed at the divisions in individual occupational groups but in a context of intensive health sector workforce reform there has been a growth in lower status occupations. This article extends debate about lower status occupations by exploring the manner in which nurses and healthcare assistants engage in boundary work to advance their occupational interests. The UK government's modernization agenda has encouraged a more prominent role for healthcare assistants and the findings confirm that this agenda has reinforced occupational boundary disputes between nurses and healthcare assistants. Tensions between nurses and healthcare assistants took particular forms influenced by gendered notions of caring work. The consequences of these boundary management strategies in terms of work undertaken, pay and status are also explored.     

邓小平时代后的四大变化(英文)

跨文化交际的难点究竟是什么?是语言,文化,还是沟通策略?中西方人交往的过程中到底存在哪些困难呢?     

Medicare and Medicaid Reimbursement Rates for Nursing Homes Motivate Select Culture Change Practices But Not Comprehensive Culture Change

Components of nursing home (NH) culture change include resident-centeredness, empowerment, and home likeness, but practices reflective of these components may be found in both traditional and “culture change” NHs. We use mixed methods to examine the presence of culture change practices in the context of an NH’s payer sources. Qualitative data show how higher pay from Medicare versus Medicaid influences implementation of select culture change practices, and quantitative data show NHs with higher proportions of Medicare residents have significantly higher (measured) environmental culture change implementation. Findings indicate that heightened coordination of Medicare and Medicaid could influence NH implementation of reform practices.     

The underreporting gap in aggressive incidents from geriatric patients against certified nursing assistants

Staff in the health care industry experience workplace aggression at a much higher rate than the general workforce. However, a large proportion of aggressive incidents go unreported, and the source of many of these incidents is patients. This study investigates aggressive incidents from patients against certified nursing assistants (CNAs; n = 76) in a sample of six geriatric care facilities. The results indicate that CNAs experienced a median of 26 aggressive incidents over the course of the 2-week study and that approximately 95% of these incidents were not reported to the facility. The present study also empirically examines reasons why nursing staff decide to report incidents. Finally, this study reveals that the experience of aggression from patients is related to subsequent organizational commitment, job satisfaction, and intent to leave the job.