Pressure ulcer point prevalence, classification, locations, and preventive measures: Insights from a Norwegian nursing home survey.

OBJECTIVE: To report data from a point pressure ulcer (PU) prevalence survey on prevalence, PU categories, locations and preventive interventions at one Norwegian nursing home. METHODS: A cross-sectional research design was used. One nursing home in Norway participated in the prevalence survey in 2020. The data were collected on one selected day. A total of 74 out of 88 residents (84.1%) participated. Descriptive statistical analyses were run. RESULTS: The overall prevalence of PUs was 27% amongst all participants in the nursing home, who together had a total of 57 PUs categorised as category I-III. One major finding was that the most common site of the PUs was on the residents' toes. Interestingly, the prevalence of PUs in the residents' sacrum was considerably low. The most frequently used PU preventive interventions were foam chair cushions, nutritional supplements and pressure-reducing heel protection. CONCLUSION: This study identified a high prevalence of PUs, predominantly on residents' toes. Although preventive strategies were implemented, their application appeared limited. Implementing obligatory care packages and annual nationwide PU surveys might be worth considering in municipalities.

Informal caregivers and assistive technology in Norwegian nursing homes.

AIM: To explore informal caregivers' experiences and perspectives concerning assistive technology (AT) in two nursing homes, through the conceptual lens of person-centredness. BACKGROUND: The integration and use of AT and a person-centred approach to care are political intentions within healthcare services, both internationally and in Norway. In nursing homes, informal caregivers are often collaborators with the staff, and can be important partners concerning the implementation of AT in a person-centred way. However, there is little knowledge about the informal caregivers' perspectives on the use of AT in nursing homes, or of whether or how they are included in the integration and use of AT. METHODS: The study had a qualitative design and comprised eleven informal caregivers of residents in two nursing homes in Norway. In-depth interviews were used for data collection. The data were analysed using content analysis. COREQ reporting guidelines were applied to ensure comprehensive reporting. RESULTS: Emerging themes highlighted the slow-going transition from old to new technology, and how the informal caregivers experienced that AT both promoted and degraded the dignity of their family members. Informal caregivers were positive to the use of technology, but have sparse knowledge and information about ATs in the nursing homes. They express a desire for AT to increase activity and safety, which promotes dignity, quality of life, and quality of the care for their family member. The informal caregivers want their family member to be seen, heard, and to get assistance on their own terms, even with regard to technology. CONCLUSION: Before AT can be implemented, informal caregivers need to be informed and listened to and included in the processes. Through their stories, one can form an idea of how important a person-centred approach is to contributing to individually tailored and introduced AT in collaboration with the informal caregivers.

Collaboration between home care staff, leaders and care partners of older people with mental health problems: a focus on personhood.

BACKGROUND: Collaboration with care partners is a political aim in recent white papers in Norway and internationally. Home care services regularly work closely with care partners, but there are many indications that the collaboration does not work satisfactorily. AIM: To explore home care staff and leaders' experiences of collaborating with care partners of older people with mental health problems through a personhood perspective. METHODS: The study had a qualitative design and comprised eight health professionals in two focus groups and in-depth interviews with three leaders in one home care district. The data were analysed using a thematic framework analysis building on previous research on personhood. criteria for reporting qualitative reporting guidelines were used to ensure comprehensive reporting. RESULTS: Four themes were identified in the analysis: 'non-negotiated relationships', 'contradictory agendas', 'weak paternalism' and 'moral compromise'. CONCLUSION: There seems to be a lack of facilitation of collaborative relationships through all levels of the home care organisation. The interactions between care partners and home care staff sometimes appear to produce low or negative levels of emotional energy, and situations where the personhood of neither of them is respected occurs. Paying attention to the four modes of being as a framework for understanding personhood creates the foundation for a person-centred approach that enhances the potential of creating stronger partnership in care relationships.

Older People's Attitudes And Perspectives Of Welfare Technology In Norway.

BACKGROUND: In Norway, as in other European countries, the ageing population is increasing rapidly. Governments seek to enable older people stay in their homes for as long as possible, and welfare technology (WT) has been proposed as a possible solution. Human behaviour modelling (HBM) is a welfare technology that identifies an individual's behaviour patterns and detects abnormal behaviours, including falls and early signs of dementia. However, the successful development of HBM WT requires the consideration of the older people's attitudes on this. AIM: The present study sought to explore attitudes and perspectives about welfare technology among older people living alone in Norway. METHODS: We used an exploratory, qualitative approach in which semi-structured, in-depth interviews were conducted with five women and four men between the ages of 79 and 91. The interviews were analysed using qualitative content analysis. RESULTS: Two categories and four subcategories were identified: 1) preferences and concerns of welfare technology (i) feeling confident-proactive approach of future technology, (ii) concerns and dilemmas, and 2) reflections of today and tomorrow- awareness of own health (i) feeling healthy, independent, self-sufficient and safe, (ii) facing own ageing- preparedness on unpredictable scenarios. The main theme, welfare technology - a valuable addition to tomorrow's homes, represents how the participants held positive and proactive attitudes towards the use of WT in their homes. CONCLUSION: Participants trusted the Norwegian healthcare system and did not rely on their families for care. Independence, autonomy, and feeling safe were essential for all participants, and most participants regarded welfare technology as empowering them to remain in their homes for as long as possible. Participants already confidently used various technologies in their daily lives. Surprisingly, they expressed no concerns about privacy, but some mention concerns about loss of autonomy and dignity. We conclude that a person-centred approach to integrating new WT is necessary.

Invisible cornerstones. A hermeneutic study of the experience of care partners of older people with mental health problems in home care services.

OBJECTIVES: To explore the lived experiences and support needs of the care partners of older people with mental health problems living at home with assistance from home care services. Care partners face significant challenges in their care role and they often feel unsupported. An understanding of their experiences may help improve home care to support their needs. METHOD: An exploratory qualitative approach was used. The study is based on the SRQR and COREQ reporting guidelines. In-depth interviews were conducted with six Norwegian care partners from two municipalities. Data were collected during 2012-2013 and 2016. The data were analysed using Gadamer's hermeneutics. RESULTS: Three themes were identified: "invisible cornerstones," "dimensions of collaboration" and "unwanted roles." CONCLUSION: Few or no routines for collaboration exist between care partners and home care, and the care partners seem to have little knowledge of legal rights. They request more information, spare time and the opportunity to remain in their original family role. However, their main focus is for the patient to receive the necessary help from home care. Home care have restricted resources for meeting these needs and share a sense of powerlessness and lack of influence over their own everyday life with the care partners. There is a need for a systematic, person-centred approach to collaboration. A correlation is necessary between what is communicated at the system level and the means of realising this in practice for home care to meet care partners' needs.

The third person in the room: The needs of care partners of older people in home care services-A systematic review from a person-centred perspective.

AIMS AND OBJECTIVES: To identify and synthesise the needs of care partners of older people living at home with assistance from home care services. BACKGROUND: "Ageing in place" is a promoted concept where care partners and home care services play significant roles. Identifying the needs of care partners and finding systematic ways of meeting them can help care partners to cope with their role. DESIGN/METHODS: This study is based on the PRISMA reporting guidelines. The systematic review of qualitative and quantitative studies was guided by the Joanna Briggs Institute methodology. RESULTS: In total, 16 studies were included in the review, eleven qualitative and five quantitative. Three main categories were revealed in the analysis: the need for quality interaction, the need for a shared approach to care and the need to feel empowered. CONCLUSION: Care partners of older people have several, continuously unmet needs. A person-centred perspective can contribute new understandings of how to meet these needs. A knowledge gap has been identified regarding the needs of care partners of older people with mental health problems. There is a need to develop a tool for systematic collaboration between home care services and care partners, so that the identified needs can be met in a more thorough, systematic and person-centred way. RELEVANCE TO CLINICAL PRACTICE: The carers in home care services need competence to identify and meet the needs of care partners. The implementation of person-centred values in home care services can contribute to meet the needs of care partners to a greater extent than today. Future research on the needs of care partners of older people with mental health problems needs to be undertaken.