How clean is the home environment?: a tool to assess home hygiene

The role of the home environment in the transmission of infectious diseases has been well described in the developing world but has received less attention in developed countries. An increasing focus on home hygiene has emerged in debates regarding the use of antimicrobial products in the home and the potential for development of resistance and in discussions regarding "when is clean too clean" and "what is clean." Studies are clearly needed to further explicate the role of the home in the spread of infectious agents, but before these can be conducted, adequate measurement tools are essential. This article describes extensive psychometric testing undertaken to develop valid and reliable methods and tools to measure home hygiene and focuses on a neighborhood that was primarily Spanish speaking in New York City. The Home Hygiene Assessment Tool described in this article can be used by clinicians and researchers to further elucidate the role of the home environment in the prevention and control of infections.     

Applying to a nursing home is a way to maintain control of life—Experiences from Swedish nursing home applicants

Background

Swedish social policy enables ageing in place with support from home-based care services despite high age and/or declining health.

Aim

This study aims to describe the daily life experiences behind the decision to apply for a nursing home placement in older adults ageing in place.

Materials and Methods

A qualitative design was chosen, and 11 semi-structured interviews were conducted and analysed using inductive qualitative content analysis.

Results

The participants described a feeling of dependence in which they had to ignore their personal privacy when receiving home-based care. They reached a turning point when ageing in place was, for several reasons, no longer considered an acceptable option. This influenced their choice to apply to a nursing home where they expected that they could maintain control over their lives.

Discussion and Conclusion

The results indicate that when enhancing ageing in place it is important to enable older adults to receive support to maintain autonomy in daily activities and to have the opportunity to age in the right place.     

Discharging older people from hospital to home: what do we know?

Aims and objectives.  The aim of this literature review was to examine empirical research to date on hospital discharge and illuminate areas in need of further exploration.
Background.  Discharging older people from hospital has long been associated with difficulties and complications. With a steady increase in the ageing population in Ireland and their use of acute hospital services, the successful management of hospital discharge is now a central concern to health service management.
Methods.  Using a seven-step approach by Stolz et al. [Scandinavian Journal of Caring Sciences (2004) Vol. 18, 111–119] a keyword database search was conducted which revealed 44 studies that matched the author's inclusion criteria.
Results.  These studies uncover aspects of the discharge process that are in need of further research, and particularly suggest more rigour in the measurement of hospital discharge outcomes.
Relevance to clinical practice.  This review focuses on a very important clinical issue given the predicted increase in the use of acute services by older people and the known vulnerabilities of the interface between hospital and community settings.     

Transition from acute care to home care nursing: how can management help?

Supervisors play a pivotal role in helping new staff adjust to home care. This article highlights some of the major areas that should be in your orientation program and approaches as based on the author's recent research.     

Parents’ experiences of transitioning to home with a very-low-birthweight infant: A meta-ethnography

Medical-technological advances and neurodevelopmental care have improved the survival of extremely- and very-low-birthweight infants born before 32 weeks' gestation. After months in neonatal care, the infants are discharged, and parents exited but full of anxiety. This review is designed as a meta-ethnography, addressing parents' discharge experiences to comprehend the synthesised research, which includes 12 eligible studies. From the analysis, we constructed three themes: ‘approaching discharge with both uncertainty and confidence’; ‘discharge as a longed-for though disordering turning point’; and ‘facing joys, worries and multiple challenges when at home’. The overarching interpretation was ‘discharge as double-edged sword’. We conclude that bringing home very-low-birthweight infants is a joyful event, yet parents also experience discharge as never-endingly worrying, as a time filled with challenges to which parents must adapt and as necessitating continuous support from knowledgeable providers.     

Do sound levels and space contribute to agitation in nursing home residents with dementia?

Individuals with dementia living in nursing homes may be exposed to non-therapeutic levels of sound. There is insufficient research examining the relationship between sound levels, personal space, and agitation in people with dementia. Using an observational designed study, 53 participants from four southeastern Wisconsin nursing homes were observed; data on sound levels, space, and agitation levels were obtained. Sound was a significant predictor of agitation. The accumulation of sound predicted agitated behavior and explained 16% of the variance, F(5, 47) = 4.520, p < 0.002, and adjusted R(2) = 0.253. The findings suggest agitation may be a clue that sound in the environment is causing stress for residents with dementia.     

Early discharge to hospital at home: should it be a matter of choice?

In recent years there has been a proliferation of Hospital at Home type schemes which facilitate the early discharge of patients to their own homes following procedures such as total hip and knee replacement. However, there is scant evidence to support their wide spread adoption. Previous studies comparing traditional in-patient rehabilitation versus early discharge to Hospital at Home have generally used a randomised controlled trial approach. Whilst this method is held in high esteem in the academic world this method of evaluation denies patients and their carers’ choice. This paper presents an overview of findings from a study comparing these treatment modalities using a quasi-experimental approach affording patients the choice. Results of the study are discussed in the context of patient and carer choice, locus of control, and coping. The development of two simple assessment tools which may assist clinicians in assessing patient and carer suitability for early discharge to Hospital at Home is presented.