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1.
Artigo em Inglês | MEDLINE | ID: mdl-35897348

RESUMO

OBJECTIVE: This study explored the perspectives of being in a youth group home during the COVID-19 pandemic from youth residents, staff, and caregivers. METHODS: We conducted semi-structured interviews with 9 youth residents, 8 group home staff members, and 13 caregivers of residents. All participants were connected to the group home before and during the COVID-19 pandemic. Thematic analysis was used to identify lived experience themes. RESULTS: Two overarching themes were identified among the youth residents-Safety response to COVID-19 and Socialization changes due to COVID-along with three subthemes: Structure leading to separation, Support and belonging amid a pandemic, and Competency. Three overarching themes were identified among the group home staff: Safety response to COVID-19, Increased responsibility, and Mental health changes because of a pandemic. Finally, three overarching themes were identified among the guardians of youth residents: Safety response to COVID-19, Belief in a mental health impact on the child, and Communication during a pandemic. Conclusions: The findings provide the experiences among three group home stakeholders. Overall, they demonstrated resilience in a setting and time when resilience was essential. Finally, the findings offer insight on the basis of which group homes/organizations can prepare for crises of a great magnitude, including vital communication elements.


Assuntos
COVID-19 , Adolescente , COVID-19/epidemiologia , Cuidadores/psicologia , Criança , Lares para Grupos , Humanos , Casas de Saúde , Pandemias
3.
J UOEH ; 44(2): 167-176, 2022.
Artigo em Japonês | MEDLINE | ID: mdl-35660682

RESUMO

The users of Group Homes (GH) for elderly people with dementia have increasing medical needs, and the number of GH that employ nurses is increasing. Due to the variety of employment patterns of nurses, we feel that it is necessary to conduct a cross-sectional survey of the practical situation of nurses and their practices. The purpose of this study was to interview eight GH nurses and prepare a questionnaire in which "Internal nurses" are defined as nurses employed by GH, regardless of whether they are full-time or part-time, and "external nurses" are defined as nurses who belong to home-visit nursing stations and visit by contract with GH. The results of a qualitatively descriptive analysis of the data obtained from the interviews revealed that 44 items were common to both the internal and the external nurses, and 2 items were added to the external nurses only, for a total of 46 items. In the future, a cross-sectional survey using this questionnaire with a large number of participants will clarify the actual, practical situation of GH nurses, and will also clarify whether there are differences between internal nurses and external nurses in practice due to differences in employment patterns.


Assuntos
Demência , Idoso , Estudos Transversais , Emprego , Lares para Grupos , Humanos , Inquéritos e Questionários
4.
Front Public Health ; 10: 747919, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35570906

RESUMO

In the US and beyond, a paradigm shift is underway toward community-based care, motivated by changes in policies, payment models and social norms. A significant aspect of this shift for disability activists and policy makers is ensuring participation in community life for individuals with disabilities living in residential homes. Despite a U.S. government ruling that encourages community participation and provides federal and state funding to realize it, little progress has been made. This study builds on and integrates the expanded model of value creation with relational coordination theory by investigating how the resources and relationships between care providers, adults with disabilities, family members, and community members can be leveraged to create value for residents through meaningful community participation. The purpose of our community case study was to assess and improve the quality of relationships between stakeholder groups, including direct care staff and managers, residents, family members, and the community through an action research intervention. This study took place in a residential group home in a Northeastern US community serving adults with disabilities from acquired brain injury. A pre-test post-test design was used and quantitative assessments of relational coordination were collected through electronic surveys, administered at baseline, and post-intervention. Direct care staff, supervisors, the house manager, and nursing staff completed the survey. Qualitative data were collected through focus groups, change team meetings, and key informant interviews. Direct care staff formed a change team to reflect on their baseline relational coordination data and identified the weak ties between direct care staff, family members, and the community as an area of concern. Staff chose to hold a community-wide open house to provide an opportunity to foster greater understanding among staff, residents, family, and community members. The change team and other staff members coordinated with local schools, business owners, town officials, churches, and neighbors. The event was attended by 50 people, about two-thirds from the community. Following the intervention, there was an increase in staff relational coordination with the community. While statistical significance could not be assessed, the change in staff RC with the community was considered qualitatively significant in that real connections were made with members of the community both directly and afterwards. Despite a small sample size, a residential setting where management was favorable to initiating staff-led interventions, and no comparison or control group, our small pilot study provides tentative evidence that engaging direct care staff in efforts to improve relational coordination with community members may succeed in building relationships that are essential to realizing the goal of greater participation in community life.


Assuntos
Pessoas com Deficiência , Lares para Grupos , Adulto , Participação da Comunidade , Pesquisa sobre Serviços de Saúde , Humanos , Projetos Piloto
5.
J Appl Gerontol ; 41(9): 1992-2001, 2022 09.
Artigo em Inglês | MEDLINE | ID: mdl-35623344

RESUMO

Sexuality is an integral part of being human throughout life. This does not change when moving into long-term care (LTC). However, the sexual health of persons living in LTC is often overlooked. This paper presents an analysis of the recently released health organizational policy: Supporting Sexual Health and Intimacy in Long-Term Care, Assisted Living, Group Homes & Supported Housing. The Intersectionality-Based Policy Analysis Framework is used to outline the policy problem, examine how this policy was developed, and evaluate its potential to address the problem. Key findings are that both the development process and the policy constructs align with principles of intersectionality, such as equity, reflexivity, and diverse knowledges. In conclusion, this analysis suggests this policy is feasible, equitable and could effectively address sexual health for persons living in LTC, while leading to an improved workplace for staff. We recommend that this policy be more widely adopted across Canada.


Assuntos
Assistência de Longa Duração , Saúde Sexual , Lares para Grupos , Política de Saúde , Habitação , Humanos , Enquadramento Interseccional , Formulação de Políticas
6.
Disabil Rehabil ; 44(7): 1141-1155, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-32645274

RESUMO

PURPOSE: Worldwide, disability systems are moving away from congregated living towards individualized models of housing. Individualized housing aims to provide choice regarding living arrangements and the option to live in houses in the community, just like people without disability. The purpose of this scoping review was to determine what is currently known about outcomes associated with individualized housing for adults with disability and complex needs. METHODS: Five databases were systematically searched to find studies that reported on outcomes associated with individualized housing for adults (aged 18-65 years) with disability and complex needs. RESULTS: Individualized housing was positively associated with human rights (i.e., self-determination, choice and autonomy) outcomes. Individualized housing also demonstrated favourable outcomes in regards to domestic tasks, social relationships, challenging behaviour and mood. However, outcomes regarding adaptive behaviour, self-care, scheduled activities and safety showed no difference, or less favourable results, when compared to group homes. CONCLUSIONS: The literature indicates that individualized housing has favourable outcomes for people with disability, particularly for human rights. Quality formal and informal supports were identified as important for positive outcomes in individualized housing. Future research should use clear and consistent terminology and longitudinal research methods to investigate individualized housing outcomes for people with disability.Implications for rehabilitationIndividualized housing models can foster self-determination, choice and autonomy for adults with disability and complex needs.Having alignment between paid and informal support is important for positive outcomes of individualized housing arrangements.A more substantial evidence base regarding individualized housing outcomes, in particular long-term outcomes, and outcomes for people with an acquired disability, is required.


Assuntos
Pessoas com Deficiência , Habitação , Adulto , Lares para Grupos , Humanos , Características de Residência
7.
J Prev Interv Community ; 50(2): 205-216, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34126040

RESUMO

This study reports results of a measure of a Romanian community's attitudes toward addiction and the hypothetical creation of self-run substance abuse recovery homes called Oxford Houses in Iași, Romania. We list five factors needed to sustain an Oxford House: affordable housing, residents following OH principles, resident income, institutional support, and community support. Because individual Oxford Houses are located in ordinary residential neighborhoods, they rely in part on community support. Descriptive data analyses provided information on four groups based on participants' status: (1) no contact with someone with alcohol misuse; (2) having a potentially alcohol addicted person(s) in their family; (3) definitely having alcohol addicted person(s) in their family; and (4) having an addicted alcohol in recovery person(s) in their family. Results indicated Romanian's favorable attitude toward alcohol addiction as a treatable condition, benefits of being part of an Oxford House, Oxford House rules and principles, and willingness to organize or to participate in events for integrating Oxford House residents into the community. These findings suggest that Oxford House could potentially be accepted by neighborhood residents in Iași, Romania, and this research could inform future efforts to create Oxford Houses in Romania.


Assuntos
Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias , Atitude , Lares para Grupos , Habitação , Humanos , Romênia
8.
J Prev Interv Community ; 50(2): 191-204, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-34096831

RESUMO

According to the National Institute on Drug Abuse, roughly 65% of the US prison population is diagnosed with a substance use disorder (SUD) and over 600,000 individuals are released from incarceration yearly. Thus, it is important to better understand the factors that allow individuals recovering from SUD to reintegrate into communities after incarceration. This study sought to understand the relationship between a personality mediator (stability) and quality of life (QOL) and belonging support (BS), as well as the relationship between this mediator and QOL and psychological sense of community (PSOC) for 131 individuals living in Oxford House (OH) recovery homes. Stability was found to mediate the relationship between BS and QOL, as well as PSOC and QOL. The findings suggest that OH is a supportive and positive recovery community for those with criminal justice backgrounds, particularly those with higher stability.


Assuntos
Centros de Tratamento de Abuso de Substâncias , Transtornos Relacionados ao Uso de Substâncias , Lares para Grupos , Humanos , Qualidade de Vida , Inquéritos e Questionários
14.
Home Health Care Serv Q ; 40(3): 218-230, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34292134

RESUMO

In Japan, the mean time spent on preparing and administering medications each day for everyone in care facilities has been reported to be 163 min. Most caregivers that administer medications to the elderly in care facilities have reported that this responsibility is a burden. We developed a drug distribution support device (DDSD) for caregivers, which was then installed in a group home and a 3-month monitoring experiment was conducted. Caregivers then answered a questionnaire survey on medication management burden pre- and post-DDSD use. The caregivers reported no difficulties associated with medication distribution using DDSD. The DDSD reduced the daily dispensing duration by an average of 3.5 min. The questionnaire survey showed no differences in items related to the reduction of errors, and the Family Caregiver Medication Administration Hassles Scale showed no reduction of burden on caregivers. However, whether the DDSD reduces medication management burden remains undetermined.


Assuntos
Lares para Grupos , Preparações Farmacêuticas , Idoso , Cuidadores , Humanos , Conduta do Tratamento Medicamentoso , Inquéritos e Questionários
15.
JAMA Netw Open ; 4(7): e2116853, 2021 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-34255048

RESUMO

Importance: Self-harm is a risk factor for suicide in adolescents, with the prevalence highest in young people in group and residential care programs. Although no established risk factors for self-harm exist, adolescents who self-harm may have decreased pain sensitivity, but this has not been systematically investigated. Objective: To assess somatosensory function using quantitative sensory testing (QST) in children and adolescents living in care grouped by the number of episodes of self-harm in the past year and compare their somatosensory profiles with community control participants to investigate associations with the incidence or frequency of self-harm. Design, Setting, and Participants: Recruitment for this cross-sectional study began January 2019 and ended March 2020. Exclusion criteria included intellectual disability (intelligence quotient <70), autism spectrum disorder, or recent serious injury. Children and adolescents aged 12 to 17 years with no underlying health conditions were recruited from local authority residential care settings in Glasgow, UK, and schools and youth groups in London and Glasgow, UK. The volunteer sample of 64 participants included adolescents ages 13 to 17 years (34 [53%] females; 50 [78%] living in residential care; mean [SD] age, 16.34 [1.01] years) with varying incidents of self-harm in the past year (no episodes, 31 [48%]; 1-4 episodes, 12 [19%]; and ≥5 episodes, 2 [33%]). Exposures: Participants were tested using a standardized QST protocol to establish baseline somatosensory function. Main Outcomes and Measures: Associations between somatosensory sensitivity, incidence and frequency of self-harm, residential status, age, gender, and prescription medication were calculated. Secondary outcomes assessed whether self-harm was associated with specific types of tests (ie, painful or nonpainful). Results: A total of 64 participants ages 13 to 17 years completed testing (mean [SD] age, 16.3 [1.0] years; 34 [53%.] females and 30 [47%] males; 50 [78%] living in group homes). Adolescents with 5 or more self-harm incidences showed significant pain hyposensitivity compared with community control participants after adjusting for age, gender, and prescription drug use (SH group with 5 or more episodes vs control: -1.03 [95% CI, -1.47 to -0.60]; P < .001). Hyposensitivity also extended to nonpainful stimuli, similarly adjusted (SH group with 5 or more episodes vs control: -1.73; 95% CI, -2.62 to -0.84; P < .001). Pressure pain threshold accounted for most of the observed variance (31.1% [95% CI, 10.5% to 44.7%]; P < .001). Conclusions and Relevance: The findings of this study suggest that sensory hyposensitivity is a phenotype of Adolescents who self-harm and that pressure pain threshold has clinical potential as a quick, inexpensive, and easily interpreted test to identify adolescents at increased risk of repeated self-harm.


Assuntos
Limiar da Dor/psicologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Distúrbios Somatossensoriais/epidemiologia , Distúrbios Somatossensoriais/psicologia , Adolescente , Criança , Estudos Transversais , Feminino , Lares para Grupos , Humanos , Incidência , Masculino , Percepção da Dor , Fenótipo , Fatores de Risco , Limiar Sensorial , Reino Unido/epidemiologia
16.
Front Public Health ; 9: 668214, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34055726

RESUMO

Individuals living in congregate settings, including those in group homes, have been disproportionately impacted by COVID-19 and may be at increased risk of exposure or infection due to underlying illness. In mid-May 2020, local public health officials responded to an outbreak of COVID-19 among staff and residents associated with a multi-residential group home that provides care for adults with intellectual and developmental disabilities. Samples were collected at 16 of the homes. In four of the homes all the residents tested positive, and in the remaining 12 houses where samples were collected, all residents tested negative. Of the 152 individuals tested, 15/58 (25.9%) residents and 27/94 (28.7%) staff were positive for SARS-CoV-2, including eight hospitalizations and four deaths. Phylogenetic analysis of genomes from this outbreak in the context of genomes from Northern Arizona shows that very few mutations separate the samples from this outbreak. A potential transmission network was developed to illustrate person-place epidemiologic linkages and further demonstrates the dynamic connections between staff and residents with respect to each group home location. Epidemiologic and genomic evidence correlate, and suggest that asymptomatic infected staff likely introduced and spread COVID-19 in this setting. Implementation of public health prevention measures alongside rapid genomic analysis can help guide policy development and guide management efforts to prevent and mitigate future outbreaks.


Assuntos
COVID-19 , Lares para Grupos , Adulto , Arizona/epidemiologia , Surtos de Doenças , Genômica , Humanos , Casas de Saúde , Filogenia , SARS-CoV-2
17.
Artigo em Inglês | MEDLINE | ID: mdl-33808617

RESUMO

People with intellectual disability (ID) and extensive support needs experience poorer quality of life than their peers whose disability is not as severe. Many of them live in residential settings that limit community participation and prevent them from exercising control over their lives. This work analyzes the extent to which professional practices are aimed at promoting the right to community living for people with ID and extensive support needs, as well as the rights that are particularly linked to it, such as the right to habilitation and rehabilitation and the right to privacy. A specific questionnaire was designed and administered to 729 adults with intellectual disability (M = 37.05; DT = 12.79) living in different settings (family home, residential facilities and group homes). Measurement and structural models were estimated using exploratory structural equation modeling. Results obtained reveal that people with extensive support needs receive less support in terms of guaranteeing their right to independent living and privacy, especially when they live in disability-related services. This study highlights the need to implement and monitor, using valid and reliable indicators, mesosystem strategies that guarantee the right to live and participate in the community, especially for individuals with ID and extensive support needs.


Assuntos
Pessoas com Deficiência , Deficiência Intelectual , Adulto , Lares para Grupos , Humanos , Qualidade de Vida , Instituições Residenciais
18.
BMJ Case Rep ; 14(2)2021 Feb 04.
Artigo em Inglês | MEDLINE | ID: mdl-33541952

RESUMO

We examined whether Instrumental Activities of Daily Living (IADL) improves with routinising therapy for a patient with frontotemporal dementia (FTD) living in a group home. The patient exhibited symptoms of agitation, apathy, disinhibition, irritability and stereotyped behaviour. The care staff experienced long-term care burden and the patient was spending time idly. An occupational therapist, in collaboration with care staff, evaluated the patient and routinised the household chores included in IADL. Consequently, a routine of household chores was established, reducing behavioural and psychological symptoms of dementia and long-term care burden, and the quality of life (QOL) of the patient improved. The results suggested that routinising IADL of the patient with FTD reduced long-term care burden and improved QOL of the patient.


Assuntos
Atividades Cotidianas , Demência Frontotemporal/terapia , Lares para Grupos , Habituação Psicofisiológica , Qualidade de Vida , Apatia , Feminino , Humanos , Humor Irritável , Assistência de Longa Duração , Pessoa de Meia-Idade
19.
Med Health Care Philos ; 24(1): 113-125, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33398489

RESUMO

This paper examines the prevalence of the ideal of "independence" in intellectual disability care in the Netherlands. It responds to a number of scholars who have interrogated this ideal through the lens of Michel Foucault's vocabulary of governmentality. Such analyses hold that the goal of "becoming independent" subjects people with intellectual disabilities to various constraints and limitations that ensure their continued oppression. As a result, these authors contend, the commitment to the ideal of "independence" - the "ethic of autonomy" - actually threatens to become an obstacle to flourishing in the group home. This paper offers an alternative analysis. It does so by drawing on a case study taken from an ethnographic study on group home life in the Netherlands. Briefly put, the disagreement stems from differing conceptualizations of moral life. Put in the vocabulary of moral anthropologist Cheryl Mattingly, the authors propose to approach the group home more from a "first-person" perspective rather than chiefly from a "third-person" perspective. They then draw on Mattingly to cast the group home as a "moral laboratory" in which the ethic of autonomy is not just reproduced but also enacted, and in which the terms of (in)dependence constantly get renegotiated in practice. What emerges is not only a new perspective on the workings of the "ethic of autonomy" in the group home, but also an argument about the possible limitations of the vocabulary of governmentality for analysing care practices.


Assuntos
Deficiência Intelectual , Lares para Grupos , Pessoal de Saúde , Humanos , Laboratórios , Princípios Morais , Autonomia Pessoal
20.
Int J Law Psychiatry ; 74: 101649, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33418151

RESUMO

This article investigates the lawfulness of isolating residents of care and group homes during the COVID-19 pandemic. Many residents are mobile, and their freedom to move is a central ethical tenet and human right. It is not however an absolute right and trade-offs between autonomy, liberty and health need to be made since COVID-19 is highly infectious and poses serious risks of critical illness and death. People living in care and group homes may be particularly vulnerable because recommended hygiene practices are difficult for them and many residents are elderly, and/or have co-morbidities. In some circumstances, the trade-offs can be made easily with the agreement of the resident and for short periods of time. However challenging cases arise, in particular for residents and occupants with dementia who 'wander', meaning they have a strong need to walk, sometimes due to agitation, as may also be the case for some people with developmental disability (e.g. autism), or as a consequence of mental illness. This article addresses three central questions: (1) in what circumstances is it lawful to isolate residents of social care homes to prevent transmission of COVID-19, in particular where the resident has a strong compulsion to walk and will not, or cannot, remain still and isolated? (2) what types of strategies are lawful to curtail walking and achieve isolation and social distancing? (3) is law reform required to ensure any action to restrict freedoms is lawful and not excessive? These questions emerged during the first wave of the COVID-19 pandemic and are still relevant. Although focussed on COVID-19, the results are also relevant to other future outbreaks of infectious diseases in care and group homes. Likewise, while we concentrate on the law in England and Wales, the analysis and implications have international significance.


Assuntos
COVID-19/epidemiologia , Lares para Grupos/ética , Lares para Grupos/legislação & jurisprudência , Casas de Saúde/ética , Casas de Saúde/legislação & jurisprudência , Isolamento de Pacientes/ética , Isolamento de Pacientes/legislação & jurisprudência , Inglaterra/epidemiologia , Ética Médica , Humanos , Pandemias , Distanciamento Físico , SARS-CoV-2 , País de Gales/epidemiologia
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