Continuity in Socialization Styles: Typologies of Socialization in the Different Life Stages of Older People.

The purpose of this research was to identify the socialization styles of the older person (such as authoritative, indulgent, authoritarian, and negligent) in three different roles: (1) nowadays as a grandparent, (2) considering the style used to educate their own children in the past; and (3), considering the socialization style they received when they were children. The sample (317 people over 65 years old with at least one grandchild aged up to 16 years old participated) received the questionnaire on socialization styles in those roles. The results showed the predominance of the indulgent style in their role as grandparents. Almost 80% showed intergenerational continuity between at least two roles, with the exception of those with a neglectful style. Continuity in socialization style is crucial to understanding the dynamics within family relationships, which have highly durable intergenerational ties.

"Now I Understand You": Changes in the Communication of Professionals in Nursing Homes After Receiving Training in the Validation Method.

Caring for older persons is a challenge for professionals who work in nursing homes. Problems in maintaining effective communication with a person with dementia in an effort to understand their needs is a major barrier to good care. Therefore, the main goals of this study were to explore communication barriers between professionals and people with dementia and to observe changes in communication patterns between them after completing Naomi Feil's introductory training in the bases of the validation method (BVM). The 11 professionals who worked in nursing homes attended a 16-hour introductory course on BVM. Participants were interviewed individually three times. The goal was to observe qualitatively the changes in relationships and communication patterns with people with dementia. The results were analyzed thematically. The professionals highlighted how, after the training, they had a different understanding of the person with dementia and a more humane perspective. These changes also reflected how the professionals experienced improvements in job satisfaction, security, and confidence. This study concluded that training nursing home staff in BVM for person-centered and human care has positive implications on how the professionals view their daily work and their way of interacting with older residents. [J Contin Educ Nurs. 2023;54(4):157-168.].

Grandchildren of grandparents with Alzheimer's disease: Exploratory study of the impact of the disease on their relationships.

The aim of this study was to describe the perception of changes that Alzheimer's disease in grandparents has made to the relationship with their grandchildren of between 6 and 13. Qualitative methodology was used. Semi-structured interviews were carried out with 25 grandchildren living in Catalonia, Spain. Participants reported a change in roles from being the care receiver to being the caregiver, changes in the activities that they did together and a positive impact on the grandparent's emotional wellbeing. In the physical sphere, sleeping problems were reported in grandchildren that cohabited with their grandparents. The feelings they described include fear of not being recognized by their grandparents and sadness, as well as satisfaction resulting from their affection and participating in caring. These findings suggest the need to provide information and resources for grandchildren and their families to enable them to deal with the disease.

Long-term care staff 's positive experiences of caring for people living with dementia: Narratives' content and lessons learned.

Research on caregiving for persons with dementia has mainly focused on its negative impact on caregivers. However, while some studies have found that positive aspects of care can also be found among informal caregivers, little attention has been paid to these positive aspects among staff working in long-term care facilities. The aim of this is study is to explore what kind of positive stories of caring for a person living with dementia staff working in long-term care facilities recall, and what kind of lessons they extracted from these experiences. Forty-two staff members currently working in four Spanish long-term care facilities (21 nursing assistants; 21 technical staff) were interviewed. They were asked about positive stories related to caring for people living with dementia. Data were analyzed using content analysis, aimed at identifying common ideas in the responses. Results showed that the type of stories were quite diverse, but can be grouped into three main themes: attachment, awakening, and mastery. The stories imply different lessons learned, including the importance of individualized care, the value of persistence and patience, and the relevance of technical knowledge and strategies to provide good care. The articles discusses how recording, reflecting on and discussing positive experiences that care staff encounter in their daily practice, may be key to skill development, reinforce job satisfaction, and improve quality of care in a person-centered care direction.

Beyond Parenting Socialization Years: The Relationship between Parenting Dimensions and Grandparenting Functioning.

Parental socialization has been studied mainly when is in process, but less is known about its long-term impact on older adults, particularly on one of the most important developmental tasks in later life: being a grandparent. Participants were 313 Spanish grandparents. The present study examined the relationship between parenting and its impacts in the long term, when the child is a grandparent. The variables examined were parenting (parental warmth and parental strictness) and grandparenting functioning (satisfaction with life, meaning of life, parent-adult child relationship quality, emotional closeness with grandchildren, and role overload). The statistical analyses were a correlation analysis and multiple linear regression analyses. A constant pattern between parenting and grandparenting functioning has been found. Warmth was positively associated with grandparenting functioning, as opposed to strictness, which did not show benefits for grandparents and even showed a significant negative relationship with an indicator of grandparenting functioning. Present findings highlight that, during the socialization years, greater parental warmth but not parental strictness might be of benefit for children at the end of their life (i.e., when they are grandparents) but also for their descendants because they have a better relationship with the two following generations (i.e., adult children and grandchildren).

Resistance to Eating in People with Dementia Living in Long-term Care Facilities: Gaps between Common and Good Practices.

OBJECTIVES: The present study aims to explore the perception of common and best practices for dealing with resistance to eating of persons with dementia living in long-term care facilities. METHODS: Forty-two staff members working in long-term care facilities were interviewed. They worked in four Spanish long-term care facilities; 21 were nursing assistants and 21 technical staff. Participants heard a vignette in which person with dementia showed resistance to eating. Participants were asked how a situation like that is commonly managed by their workmates, and how the situation should be managed. Responses were content-analyzed. RESULTS: Strategies mentioned by participants were quite diverse and did not converge on common ground that harmonizes their responses. Less than half of the participants considered person-centered strategies as a best practice. Those strategies were lower on assistant carers, compared to technical staff. CONCLUSIONS: Resistance to eating is a common situation faced by professionals. Nonetheless, there is not a common procedure to deal with this situation. Resistance to eating was seen more as a problem to be eradicated than a behavior to be understood. CLINICAL IMPLICATIONS: Staff development initiatives are necessary in relation to mealtime situations. They should consider work position and competencies needed by assistant carers.

Exploring the Benefits of Proactive Participation among Adults and Older People by Writing Blogs.

The use of Information and Communication Technologies (ICTs) for information-seeking, social contact and leisure activities is increasing in adults and older people. However, little is known about adults and older people who are already actively using ICTs to write a blog. The aim of this paper is to describe the benefits adults and older people gain from having a blog. Twenty-three older adult bloggers (aged 60-83 years; most of them with college degrees and retired) from Spain who, at the time of the study had an active blog were interviewed. A thematic analysis identified four different benefits related to blogging: (1) a general sense of satisfaction from producing the blog; (2) relational benefits; (3) cognitive benefits; and (4) identity benefits. Results showed that adults and older people experienced a variety of benefits that broadens the distinction between personal and social benefits found in previous research. Blogging in later life challenges the traditional passive/consumer and online user experience view of adults and older people and seems to be a good example of proactive participation through websites.

Post-Traumatic Growth among Older People after the Forced Lockdown for the COVID-19 Pandemic.

We explored post-traumatic growth (PTG) in older adults immediately after the forced lockdown in Spain during March to April, 2020, due to the COVID-19 pandemic. The study also tried to identify the variables that predict PTG, focusing on the experience of COVID, sociodemographic variables, and social resources. In total 1,009 people aged 55 years and older participated in the study and completed an online questionnaire comprising the following elements: The short form of the Post-traumatic Growth Inventory (PTGI-SF), sociodemographic and social resources questions, and their experiences of COVID-19 (if they had been infected themselves or if they had experienced the loss of someone close). Results showed that only a quarter of the participants experienced higher PTG after the forced lockdown, with only age and social resources being correlated with scores on the PTGI-SF. Looking at the strengths that older adults put into action to combat the pandemic and its social and health consequences could be an important consideration when planning future social policies for this and other pandemics.

Managing apathy among people with dementia living in institutional settings: Staff's perceived gap between common and best practices.

The aim of this study is to explore how staff manage apathy involving a person living with dementia (PLWD). Forty-two staff members working in four Spanish long-term care facilities were interviewed; 21 were nursing assistants and 21 technical staff. They read a vignette about a PLWD presenting apathy. Participants were asked (1) how a situation like that is commonly managed, and (2) how it should be managed. Responses were content-analyzed. Most participants (88.1%) mentioned having experienced a situation similar to the one described in the vignette. Behavior-focused strategies and person-centered strategies were the most frequently mentioned. As for best practices, person-centered strategies emerged as the preferred alternative, and technical staff mentioned them more frequently than assistant carers. Our findings stress the importance of organizational guidelines and staff development in the management of apathy in PLWD.

'I do it my way': long-term care staff's perceptions of residents' sexual needs and suggestions for improvement in their management.

This study is aimed at exploring to what extent staff perceive older residents in long-term care facilities (LTCFs) as still having sexual needs, and how they think care in relation to sexual issues could be improved. The sample was self-selected and comprised 2115 staff members (including managers, technical and care assistants) employed at 152 Spanish LTCFs. Data were collected in the second half of 2016. Participants were asked to estimate the proportion of older residents who had sexual needs in their institution and, by means of open-ended questions, they were also asked about how they satisfied such needs and how to improve care in relation to sexual issues. Responses to the open-ended questions were analysed using content analysis. Differences were assessed according to participants' work position. Results showed that most participants did not see sexual needs as being present in many (or even any) older people living in LTCFs. Masturbation was the most common way staff thought residents' sexual needs were being satisfied. The participants mentioned a broad range of measures to improve care regarding sexual issues, including providing more training opportunities for staff, guaranteeing privacy and improving negative attitudes held by family, residents or staff members. Work position influenced participants' responses: managers and technical staff were more likely to recognise sexual needs among residents, perceived a greater need for training, and proposed more ambitious and far-reaching improvements than care assistants.

Effectiveness of the Validation Method in Work Satisfaction and Motivation of Nursing Home Care Professionals: A Literature Review.

The purpose of this study was to carry out a literature review on the effectiveness of the validation method (VM) in job satisfaction and motivation of care professionals working with older people in nursing homes. The review was carried out in specialised databases: Scopus, PsychINFO, PubMed, Web of Science (WOS), Google Scholar, Scielo, and Cochrane Database of Systematic Reviews. 9046 results were obtained, out of which a total of 14 studies met the inclusion criteria: five quantitative, four qualitative, one single case series, two quasi-experimental and two mixed methods studies. The results of the analysed studies report that the VM can be an effective tool that facilitates communication and interaction in care, reducing levels of stress and job dissatisfaction among care professionals. The VM facilitates communication between professionals and older people with dementia, and improves the management of complex situations that may arise in care, directly influencing a reduction in work stress and increasing job satisfaction.

Sexual harassment from older residents at long-term care facilities: is it really part of the job?

OBJECTIVES: To explore the extent to which staff members in long-term care facilities (LTCF) have experienced situations of sexual harassment, how they commonly and ideally manage the situation, and how their work position influences their responses. DESIGN: Cross-sectional quantitative study, using the vignette technique. METHOD: A total of 2,196 staff-members who were currently working in Spanish LTCF participated in the study. Data were collected using a self-administered questionnaire. Questions regarding sexual harassment were analysed by a vignette that described a case of sexual harassment. Participants had to choose common and best practices for dealing with the case, and report the frequency with which they had experienced similar situations. RESULTS: The results indicate that 29.9% of participants had experienced an episode of sexual harassment in a LTCF similar to the one presented in the vignette. Responses to the situation were diverse and there were significant differences between common and perceived best practices. Differences were also found depending on the work position of the participant (manager, technical staff or nursing assistant). CONCLUSIONS: There is a need for a fuller recognition of the sexual needs of older people. However, the presence of inappropriate sexual behavior must also be acknowledged. The right of staff to work in an environment free of harassment must be respected. The need for explicit institutional guidelines and training opportunities is discussed.

Staff responses to residents exposing their genitals in public in long-term care settings: The gap between common and perceived best practices.

AIMS AND OBJECTIVES: To explore staff reactions to residents' behaviour consisting in exposing their genitals in public, and to differentiate between what is perceived as common practice (what most staff do) and best practice (the best possible approach). BACKGROUND: The presence of inappropriate sexual behaviours (ISBs) in long-term care facilities poses practical and ethical dilemmas since they may impinge on the rights of others (staff and residents) and thus need to be adequately monitored and managed. However, no studies have focused on how staff handle ISBs, and particularly exposing oneself in public. METHODS: A total of 2,175 people working in 152 Spanish LTC facilities participated in the study. They were presented with a vignette describing a resident exposing his/her genitals in public, and they were asked what they think most of their workmates would do and what they think should be done in that situation. The STROBE checklist was used to enhance the quality and transparency of the research. RESULTS: Approximately one-third of participants (32.4%) reported having experienced behaviours such as the one described in the vignette. Staff reactions underline the predominance of restrictive practices. However, if prompted to think in terms of best practice, supportive reactions increased in frequency. Finally, factors such as work position have an influence on perceived common and best practices, with care assistants generally holding more restrictive views than directors or technical staff. CONCLUSIONS: Around one-third of staff members, and particularly those in managerial or technical positions, had witnessed residents exposing their genitals in public. However, there is no common ground among staff regarding the best way to handle the situation. RELEVANCE TO CLINICAL PRACTICE: Our findings stress the importance of organisational policies and workplace training in the management of challenging behaviours such as exposing oneself.

Expresión sexual y regulación de la sexualidad en residencias de personas mayores / Sexual expression and sexuality regulation in Spanish long-term care homes for the elderly

Objetivos: El estudio tenía tres objetivos: (1) determinar la frecuencia con la que profesionales que trabajan en residencias de mayores estiman diversos comportamientos sexuales de los residentes; (2) cuantificar la presencia en esas instituciones de medidas y procedimientos destinados a garantizar los derechos sexuales de los mayores; y (3) determinar los factores que predicen la mayor o menor presencia de esas medidas. Material y métodos: Ciento sesenta directores de residencia y personal de gestión, y 623 técnicos contestaron un cuestionario autoadministrado que incluía preguntas sobre la frecuencia con la que se daban ciertos comportamientos sexuales en su residencia, un inventario para valorar la implementación de medidas para favorecer la expresión sexual y la versión española del Person-centered Care Assessment Tool. Resultados: Ciertos comportamientos sexuales, como los besos y abrazos o la masturbación son muy frecuentes en las residencias de mayores. Muchos participantes habían presenciado comportamientos sexuales inapropiados, como el exhibicionismo (39%) o los tocamientos a profesionales (27%). Las normas dirigidas a garantizar los derechos sexuales de los residentes fueron las medidas más presentes en las residencias, mientras que las relacionadas con la formación e información, o con la disponibilidad de recursos y materiales facilitadores, lo eran mucho menos. Los directores y personal de gestión eran mucho más optimistas respecto a la presencia de estas normas que los técnicos. Una mayor implementación en la residencia de modelos ACP se relacionaba con una mayor presencia de regulación respecto a la sexualidad. Conclusión: Aunque en las residencias de mayores los comportamientos sexuales son relativamente frecuentes, existe un gran margen de mejora para la implementación de medidas que garanticen y tengan en cuenta la expresión sexual de los residentes. Los modelos de atención centrada en la persona pueden ayudar a preservar los derechos sexuales de las personas que viven en residencias

Objectives The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents' sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies. Methods A total of 160 Directors of Nursing and 623 technical staff from Spanish long term care residential facilities completed a self-administered questionnaire including ítems to assess the experience and estimated frequency of different sexual expressions, an inventory of policies regarding sexual expression, and the Spanish version of the Person-Centred Care Assessment Tool. Results Certain sexual behaviours, such as kisses and hugs, or masturbation, are very frequent in nursing homes. Many participants have reported to staff members on having witnessed inappropriate sexual behaviours, such as exhibitionism (39%) or unwanted touching (27%). Policies in relation to guaranteeing residents' sexual rights were the most frequently mentioned. In contrast, there were fewer participants who mentioned policies regarding training or availability of helpful materials and resources. Factors such as occupational level (Directors of Nursing vs.technical staff), personal education, the centre commitment to person-centred care, and estimated frequency of sexual behaviour were associated with a higher presence of sexual expression policies. Conclusion Although sexual behaviours among residents are quite frequent, there is still room for improvement in policies that support residents' expression of sexuality. Person-centred care models might help to guarantee sexual rights of older people living in long-term care facilities

Involving institutionalized people with dementia in their care-planning meetings: Impact on their quality of life measured by a proxy method: Innovative Practice.

The objective of the study was to assess the impact of an intervention in which people with dementia attended meetings to discuss their individual care plans on their quality of life. Fifty-two older people (M = 86.7 years, SD = 7.3) diagnosed with moderate-to-severe dementia living in four nursing homes in Spain participated in the study. The intervention was implemented with 27 residents at two of the nursing homes; the other 25 cases at the other two homes acted as controls. A proxy measure of quality of life was used. Improvements were found in quality of life as assessed by staff members, in both within and between-group comparisons, which suggests that including older people with dementia in care-planning meetings may improve their quality of life. However, further controlled studies are needed to confirm these preliminary results.

Disclosing a LGB Sexual Identity When Living in an Elderly Long-Term Care Facility: Common and Best Practices.

This study aims at exploring staff perceptions of common and best practices toward a situation in which an older resident discloses their non-heterosexual sexual identity, differentiating between gay men, lesbians, and bisexuals. A total of 2,254 staff members from 96 Spanish long-term care facilities took part in the study. They were asked about what they think most of their workmates would do and what they think should be done in a situation in which an older resident discloses his/her non-heterosexual sexual orientation. The results indicate that, in general, staff's attitudes to non-heterosexual older residents' disclosure of their sexual identity are quite tolerant and open. However, differences in staff perceptions of common and best practices indicate that there is still potential for improvement. Results underline that factors such as residents' sexual identity (and particularly, bisexuality), generation, professional position, and the prevailing model of care influence staff responses.

[Sexual expression and sexuality regulation in Spanish long-term care homes for the elderly]. / Expresión sexual y regulación de la sexualidad en residencias de personas mayores.

OBJECTIVES: The study had three objectives: (a) To determine how staff perceives the frequency of different sexual expressions in long-term care facilities for older people; (2) to quantify policies aimed at guaranteeing residents' sexual rights in such institutions, and (3) to determine factors influencing the presence of these kind of policies. METHODS: A total of 160 Directors of Nursing and 623 technical staff from Spanish long term care residential facilities completed a self-administered questionnaire including ítems to assess the experience and estimated frequency of different sexual expressions, an inventory of policies regarding sexual expression, and the Spanish version of the Person-Centred Care Assessment Tool. RESULTS: Certain sexual behaviours, such as kisses and hugs, or masturbation, are very frequent in nursing homes. Many participants have reported to staff members on having witnessed inappropriate sexual behaviours, such as exhibitionism (39%) or unwanted touching (27%). Policies in relation to guaranteeing residents' sexual rights were the most frequently mentioned. In contrast, there were fewer participants who mentioned policies regarding training or availability of helpful materials and resources. Factors such as occupational level (Directors of Nursing vs.technical staff), personal education, the centre commitment to person-centred care, and estimated frequency of sexual behaviour were associated with a higher presence of sexual expression policies. CONCLUSION: Although sexual behaviours among residents are quite frequent, there is still room for improvement in policies that support residents' expression of sexuality. Person-centred care models might help to guarantee sexual rights of older people living in long-term care facilities.

Grandparent Visitation Rights in Spain: Which Psychosocial Arguments are Taken into Account to Grant or Deny Visits?

The purpose of this study was to assess reports by psychologists and social workers in lawsuits regarding grandparent visitation rights in Barcelona (Spain). Seventy-three reports written during a five-year period were analysed Sixty-three per cent of cases recommended grandparents being granted visitation rights. A content analysis of the reports revealed that they were more likely to contain negative rather than positive comments about a family member (especially grandparents). Finally, the analysis showed that aspects such as grandparent abilities and a hidden agenda on the part of grandparents were associated with a recommendation that a visitation schedule be denied, whereas the presence of a strong bond between grandparents and the grandchild was related to a favourable recommendation. The article discusses directions for further research and the potential value of drawing up guidelines to assess grandparent rights in the event of family conflict.

Involving institutionalised people with dementia in their care-planning meetings: lessons learnt by the staff.

BACKGROUND: Applying a person-centred care (PCC) approach is an aspiration for many services attending people with dementia (PwD). However, the implementation and assessment of PCC practices represent a challenge to health professionals. AIM: To evaluate the impact on staff of a programme aiming to involve people with dementia (PwD) in their individualised care-planning (ICP) meetings in long-term residential settings; specifically, to explore the lessons that staff perceived they had learned from the experience. METHODS: Twenty-one staff members working in residential facilities for older people were interviewed after the programme. Responses to two questions ('Do you think that your work has been affected in any way by the attendance of PwD at ICP meetings?' and 'Have you learnt something new as a result of these meetings?') were submitted to thematic analysis. RESULTS: Eighteen of the 21 participants identified at least one lesson they had learned from the experience. The lessons could be grouped under three main headings: (i) an increase in their understanding of PwD, (ii) questioning of their own care practices, and (iii) an improvement in teamwork. CONCLUSION: The involvement of PwD in ICP meetings had a positive impact on staff. They stated that the experience encouraged them to develop PCC-compatible attitudes and modify the way they treat PwD, thus improving the quality of care they deliver. The experience also seemed to empower staff (particularly the lesser trained members) and increase the cohesion of working teams.