Cultivating a Patient-Centered Environment (CAPE): Renovations in Long-Term Chronic Care

Abstract Achieving institutional goal of full, person-centered care was encumbered by an outdated structural “hospital model” at one long-term care facility that undertook building renovations, transforming long hallways into “neighborhood” of compact households. Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of person-centered care. RU residents indicating they could “eat when I want” increased 75% to 81% at follow-up and decreased 17% for NRU residents. Sixty-seven percent of RU residents reported bathing “when they want” in contrast to 40% of NRU residents. Most RU residents agreed, “staff act on my suggestions.”More RU residents (68% vs 53%) agreed: “I spend time with other like-minded residents” and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests. RU residents more often reported (50% vs 37%) “people ask for my help or advice.” Similar differences were observed with “it is easy to make friends here,” 67% RU residents responding affirmatively. RU residents reporting “feeling down” improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported “feeling down” at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence. Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood. Physical unit renovations appear to enhance implementation of person-centered care model.

Introduction: The Late Life Function and Disability Instrument (LLFDI) is a valid self-report tool that quantifies disability based on activity limitations and participation restrictions in everyday life.Both the original longer tool (LLFDI) and the shorter computer adaptive version (LLFDI-CAT) offer practitioners a method for measuring function independent or in conjunction with performance-based assessment.Objectives: Examine scores of the LLFDI and LLFDI-CAT for measuring disability in older adults who are receiving rehabilitation services in community and institution settings.Method: A secondary data analysis was conducted comparing scores from occupational therapy evaluations with older adults from 3 groups: 1) older adults in primary care using the LLFDI; 2) older adults in primary care using the LLFDI-CAT; older adults in a skilled nursing facility (SNF) using the LLFDI-CAT.Results: Mean scores for Activity Limitation and Participation Restriction were lowest for older adults in a SNF indicating greater disability.A one-way Analysis of variance on ranks showed a main effect for Activity Limitation, χ2 (2) = 22.267, p < 0.001, and Participation Restriction, χ2 (2) = 60.372,p < 0.001.Post-hoc analyses revealed significant differences between groups based on tool (i.e.LLFDI vs. LLFDI-CAT) for Activity Limitations and setting (i.e.primary care vs. SNF) for Participation Restriction.Conclusion: The LLFDI-CAT may be the preferred instrument to measure disability in older adults across treatment settings.Additional research is warranted to understand how personal and environmental factors influence LLFDI-CAT outcomes.Achieving institutional goal of full, person-centered care was encumbered by an outdated structural "hospital model" at one long-term care facility that undertook building renovations, transforming long hallways into "neighborhood" of compact households.Quality of Life Survey and Long-term Care Minimum Data Set generated data at baseline and 1-year follow-up, comparing renovated(RU) and non-renovated unit(NRU) residents (n=36) to evaluate achievement of personcentered care.RU residents indicating they could "eat when I want" increased 75% to 81% at follow-up and decreased 17% for NRU residents.Sixty-seven percent of RU residents reported bathing "when they want" in contrast to 40% of NRU residents.Most RU residents agreed, "staff act on my suggestions."MoreRU residents (68% vs 53%) agreed: "I spend time with other like-minded residents" and more RU residents (86% vs 43%) reported opportunity to explore new skills, interests.RU residents more often reported (50% vs 37%) "people ask for my help or advice."Similar differences were observed with "it is easy to make friends here," 67% RU residents responding affirmatively.RU residents reporting "feeling down" improved, moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported "feeling down" at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence.Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood.Physical unit renovations appear to enhance implementation of person-centered care model.

to make friends here," 67% RU residents responding affirmatively.RU residents reporting "feeling down" improved,
moving from 46% to 50% disagreeing with this item with while increased number of NRU residents (18% to 22%) reported "feeling down" at follow-up.Improvement with independent performance of bed mobility, transfer, walking, and dressing among RU residents was observed while NRU residents had decreased percentages of independence.Evaluation of resident outcomes demonstrated improvement with personal choice, activities, personal relationships, functional independence and mood.Physical unit renovations appear to enhance implementation of person-centered care model.


Session 9395 (Poster) Multidimensional Aspects of Long-Term Care


DO DAYTIME ACTIVITY, MOOD AT BEDTIME AND UNIT TUMULT PREDICT NIGHTTIME SLEEP QUALITY OF LONG-TERM CARE RESIDENTS?

Murad Taani, 1 and Christine Kovach, 2 1.University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States, 2. University of Wisconsin Milwaukee, Milwaukee, Wisconsin, United States Innovation in Aging, 2021, Vol. 5, No. S1

DO DAYTIME ACTIVITY, MOOD AT BEDTIME AND UNIT TUMULT PREDICT NIGHTTIME SLEEP QUALITY OF LONG-TERM CARE RESIDENTS?
Murad Taani, 1 and Christine Kovach, 2 1.University of Wisconsin-Milwaukee, Milwaukee, Wisconsin, United States, 2. University of Wisconsin Milwaukee, Milwaukee, Wisconsin, United States Innovation in Aging, 2021, Vol. 5, No. S1





