Journal of Housing for the Elderly最新文献

{"title":"“Magic Happens Here”: Environmental Serenity in Residential Hospice Care","authors":"D. Waldrop, J. McGinley","doi":"10.1080/02763893.2018.1505455","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505455","url":null,"abstract":"Abstract The purpose of this study was to explore the unique interaction between the care that is provided in and the environmental features of hospice residences. Interviews with 40 professionals from eight hospice residences focused on elements of care. Visual content analysis was conducted with 187 photographs of internal and external environments. Three themes illuminated residential care as (a) patient-family-centered, (b) flexible, and (c) comfort-focused. Six environmental features are described as (a) site and context, (b) nature connectivity, (c) arrival spaces, (d) communal spaces, (e) private spaces, and (f) transitional spaces. The interaction between residential care and the environmental features creates environmental serenity.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505455","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42183033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Leon A. Pastalan (1930–2018)","authors":"Benyamin Schwarz","doi":"10.1080/02763893.2018.1505457","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505457","url":null,"abstract":"","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505457","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49279819","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Last Habitat: Living and Dying in Residential Care Facility","authors":"Benyamin Schwarz, R. Molnar, J. Benson, R. Tofle","doi":"10.1080/02763893.2018.1505461","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505461","url":null,"abstract":"Abstract This article is a part of a larger study regarding the place of dying. Through narrative analysis methods, we strived to obtain rich descriptions and idiosyncratic accounts of the experience of dying in institutional settings, predominately in the nursing home. The quality of the physical environment can impede or greatly enhance the extent to which a disabled older person can remain in his or her own home. Most of long-term care is provided by family members. However, as the condition of the care recipient deteriorates and the stress level of the caregiver increases, the need to supplement the informal care with formal care resources grows. Consequently, frail older adults may be relocated to a residential care facility. In other cases they may be discharged from a hospital to these institutional settings. Nursing homes are considered the last resort for frail, old people. Despite attempts to improve the environment of long-term care settings through “cultural change,” the overriding theme of much of the literature about the nursing home experience is one of rejection, loss, and in some extreme accounts, a “double burial” that equates relocation to a nursing home with a person’s final terminus of life.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505461","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47539325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Place of Death and Dying: Introduction","authors":"Benyamin Schwarz, J. Benson","doi":"10.1080/02763893.2018.1505459","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505459","url":null,"abstract":"The subject of death is of a considerable interest to all of us, as it has been since the beginning of civilization. However, the place of dying has seldom been studied in the field of environmental gerontology. The concept of aging in place is often explored in the field, but the discussion normally stops short of the last stages as if aging in place is a condition that never ends. Still, dying is part of the inevitability of aging. And even though a number of scientists and statisticians argue whether people die of old age, there is plenty of evidence that life has its natural, inherent limits. Clearly, intrinsic physical developments associated with aging inevitably cause an individual to become more vulnerable to mortality, which “ends in all cases we know of, in death” (Ehrenreich, 2018, p. xv). Even the most successful aging process eventually involves accumulation of disabilities as a result of the ongoing conflict at the cellular level of our bodies. Sadly, “successful” aging is an ideal that hardly accommodates the realities of decline and death (Ehrenreich, 2018). Conforming to the modern demographic pattern, the majority of people in the Western society reach old age, and consequently they are destined to die of one of its ravages. No matter how good our medical care or our exercise and hygienic regimens are, our ability to control the biological continuum between “normal” aging and disease is very limited. We are all susceptible to chronic diseases and death (Cole, 1992), as the paradoxical nature of aging and death discloses.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505459","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45853588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care Pathways for the Dying Patients: Physician Perspective","authors":"Benyamin Schwarz, J. Benson","doi":"10.1080/02763893.2018.1505463","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505463","url":null,"abstract":"Abstract The overriding care philosophy in medicine is to prevent death, rather than focus on dying. However, increasing longevity in most parts of the world has resulted for many people in prolonged periods of declining health toward the end of life. This has complicated our understanding of when the dying process begins. As a result, there has been a growing movement within society and among health care systems to focus on finding ways to contribute to the quality of life of patients just before they die. The modern hospice and palliative-care movement has gained distinction as an alternative way of looking at health care. These care philosophies perceive dying as a natural part of the life cycle. Staff members prioritize comfort and quality of life over longevity. However, the goals of hospice and palliative care are often misunderstood by the public. This article is based on interviews with two palliative-care physicians that were conducted as part of a larger study about the place of dying. The goal of these interviews was to obtain the physician perspective of dying at a hospital, at home, and in an institutional setting, as well as to provide readers greater clarity on the palliative and hospice care perspectives within these contexts.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505463","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45879035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environments of Dying, Death, and Caregiving at End-of-Life","authors":"J. Benson, Benyamin Schwarz","doi":"10.1080/02763893.2018.1505458","DOIUrl":"https://doi.org/10.1080/02763893.2018.1505458","url":null,"abstract":"The process of dying, the provision of care associated with the end of life, and rituals of mourning and memorialization are all profoundly shaped by the physical places and social environments in which death occurs. Matters of dying are not only physical, emotional or spiritual, they are also relational, cultural, and political. Decision making about medical interventions, caregiving, location of death, and burial are complicated by numerous factors. For example, diagnosis and life stage of the dying, patient/caregiver family dynamics, relationships with physicians and nurses, personal beliefs about death and dying, and the ethos of end-of-life care espoused by varying health care systems influence our evaluations of what it means to experience a “good death,” and our bereavement. This special issue of the Journal of Housing for the Elderly includes six empirical articles focused on the environments of dying, death, and caregiving at end-of-life for older adults. The first four articles constitute a collection of papers by researchers at the University of Missouri that are derived from a larger, narrative project addressing older patients’, family caregivers’, and physicians’ perspectives about the process of dying in three different environments: home, nursing home, and hospital. A broad introduction entitled “Place of Death and Dying: Introduction” precedes the four empirical articles that developed from this project. The fifth and sixth articles in this issue constitute original research from others that address dying in residential hospice facilities, and places of burial and memorialization practices, respectively. In the first empirical article, “The Motivations and Consequences of Dying at Home: Family Caregiver Perspectives,” the authors present a rich understanding about the meaning of home in the context of dying. Relational aspects of death and dying, especially relating to family and the co-conspiratorship between family, home, and experiencing a “good death,” are major themes derived from this study. The authors challenge the notion that dying at home is synonymous with dying well, and recommend that practitioners and caregiving families focus less on controlling the physical location of death and instead focus on evoking the “essence of home” regardless of location. The second article, “The Last Habitat: Living and Dying in a Residential Care Facility,” addresses patient and family caregiver perspectives about the phenomenon of dying in a residential care facility or nursing home. Based on the findings, the authors suggest that dying in a nursing home is arguably less dignified and more isolating than dying at home or in a hospital due to the chronic health conditions that typify nursing home residents and the ways nursing homes are physically, financially, and operationally structured. In the next article, “The ‘Medicalized Death’: Dying in the Hospital,” the authors present four cases of caregiver perspectives on dying in the hos","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1505458","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45932514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining the Nursing Home Physical Environment Through Policy-Driven Culture Change","authors":"Emily Roberts, Alana Pulay","doi":"10.1080/02763893.2018.1431586","DOIUrl":"https://doi.org/10.1080/02763893.2018.1431586","url":null,"abstract":"ABSTRACT A critical need exists to challenge approaches to nursing home care due to rigid organizational factors and hospital-like culture. It has been argued that resident care needs to move toward a person-centered approach by addressing the organizational, social, and physical environments in nursing home facilities, a process often known as culture change. In response to this need, the Centers for Medicare & Medicaid Services (CMS) has created funding for pay for performance (P4P) nursing home incentive programs to allow nursing home providers to receive CMS reimbursements for culture change in the facilities. Through care staff interviews, site observations, and a document review, this qualitative study assesses the impact of a Midwestern state P4P incentive program in three participating nursing homes. Using an environment and behavior (E-B) policy orientation framework, this study examines culture change through a focus on policy, the physical environment, place attachment, and social and psychological processes in the study settings.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1431586","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49531970","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiences of a Mass Interinstitutional Relocation for Long-Term Care Staff","authors":"S. Canham, M. Wada, L. Battersby, M. Fang, A. Sixsmith","doi":"10.1080/02763893.2018.1431582","DOIUrl":"https://doi.org/10.1080/02763893.2018.1431582","url":null,"abstract":"ABSTRACT This research explored long-term care (LTC) staff perceptions and experiences of working in LTC and providing care to residents following a mass interinstitutional relocation. In-depth, semistructured interviews were conducted with 63 LTC workers. Thematic analyses revealed three overarching themes related to how staff members perceived their relationships with other staff members following relocation. The first theme, post-relocation relationships between staff members, included the subthemes “Staff are segregated from each other” (physical distance) and “We were a family” to “barely say hi” (psychological distance). The second theme, post-relocation stress, has two subthemes: “Staffing is our big issue” and consequences of stress: absenteeism and leave. The third theme is recommendations for improving and managing staff relationships post-relocation. Relationships among staff members are integral to working in LTC and providing care to residents following a mass interinstitutional relocation. Recommendations for improving staff relationships and morale are suggested.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1431582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41313708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vulnerable African American Seniors: The Challenges of Aging in Place","authors":"James H. Johnson, Jr., Huan Lian","doi":"10.1080/02763893.2018.1431581","DOIUrl":"https://doi.org/10.1080/02763893.2018.1431581","url":null,"abstract":"ABSTRACT American Community Survey data are used to develop typologies of the generational dynamics and living arrangements of the estimated 1.6 million African American older adult households who will likely encounter the most difficulty aging in place. Policy recommendations and strategies are offered to address the specific barriers and challenges that must be overcome in order for these older adults to successfully live out their lives in their homes and community.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1431581","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43651485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions about Compliant Flooring from Senior Managers in Long-Term Care","authors":"C. Lachance, V. Zaborska, P. Leung, F. Feldman, S. Robinovitch, D. Mackey","doi":"10.1080/02763893.2018.1431584","DOIUrl":"https://doi.org/10.1080/02763893.2018.1431584","url":null,"abstract":"ABSTRACT This study explored barriers and facilitators to adoption of compliant flooring as a fall injury prevention strategy within long-term care from the perspective of 18 long-term care senior managers. In-depth interviews were recorded, transcribed, and analyzed using the Framework Method. The most important organizational facilitators to adoption were potential for injury prevention and long-term care staff's openness to change. The most important organizational barriers to adoption were negative effects to long-term care staff and financial considerations (i.e., cost and lack of funding). The most important general organizational considerations were uncertainties about clinical effectiveness, effects on long-term care staff, and flooring performance. Overall, compliant flooring was viewed positively for long-term care. The findings also suggest an opportunity for knowledge translation to inform long-term care senior managers about the existing evidence on compliant flooring.","PeriodicalId":46221,"journal":{"name":"Journal of Housing for the Elderly","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/02763893.2018.1431584","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46015223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}