Abstract
Objectives: Home-like models of residential care offer different services including more personal care attendants (PCAs) to implement culture change compared to standard models. This study examines associations between staffing structures and quality of life and hospitalisations for the residents.
Methods: The Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study investigated questions prioritised in a collaborative between researchers, aged care providers and consumers. These were to examine models of care and quality of life in older Australians. Residents (n=541) from 17 non-for profit residential facilities in Australia participated.
Results: Within these high-quality facilities, direct care hours per-resident-per-day were significantly higher in home-like models compared to standard models (0.08 higher (5 minutes), p=0.006). Home-like models had a significantly higher staffing ratio for PCAs to nursing staff (registered nurses and enrolled nurses) compared to standard models (mean (SD) 91.6 (3.6) vs. 66.3 (8.4) p<0.001) and significantly higher staff training costs per resident (mean (SD) $1492.45 vs. $988.99 p<0.001). Direct care hours or a higher ratio of PCAs to nurses were not significantly associated with quality of life (measured with the DEMQOL and EQ-5D-5L) or hospitalisations. However, a higher PCA ratio was associated with fewer emergency visits (with admission: IRR 0.60 95%CI 0.43-0.84, p=0.003 and without admission: IRR 0.40 95%CI 0.25-0.67, p<0.001), after adjustment for potential confounding factors.
Conclusions: Higher direct care hours, similar quality of life and positive hospitalisation outcomes for residents can be achieved with higher PCA:nurse ratios coupled with high staff training, but further research is needed.
Methods: The Investigating Services Provided in the Residential Environment for Dementia (INSPIRED) study investigated questions prioritised in a collaborative between researchers, aged care providers and consumers. These were to examine models of care and quality of life in older Australians. Residents (n=541) from 17 non-for profit residential facilities in Australia participated.
Results: Within these high-quality facilities, direct care hours per-resident-per-day were significantly higher in home-like models compared to standard models (0.08 higher (5 minutes), p=0.006). Home-like models had a significantly higher staffing ratio for PCAs to nursing staff (registered nurses and enrolled nurses) compared to standard models (mean (SD) 91.6 (3.6) vs. 66.3 (8.4) p<0.001) and significantly higher staff training costs per resident (mean (SD) $1492.45 vs. $988.99 p<0.001). Direct care hours or a higher ratio of PCAs to nurses were not significantly associated with quality of life (measured with the DEMQOL and EQ-5D-5L) or hospitalisations. However, a higher PCA ratio was associated with fewer emergency visits (with admission: IRR 0.60 95%CI 0.43-0.84, p=0.003 and without admission: IRR 0.40 95%CI 0.25-0.67, p<0.001), after adjustment for potential confounding factors.
Conclusions: Higher direct care hours, similar quality of life and positive hospitalisation outcomes for residents can be achieved with higher PCA:nurse ratios coupled with high staff training, but further research is needed.
| Original language | English |
|---|---|
| Pages | 69-69 |
| Number of pages | 1 |
| Publication status | Published - 2016 |
| Event | NNIDR Australian Dementia Forum - Brisbane, Australia Duration: 1 May 2016 → 3 May 2016 |
Conference
| Conference | NNIDR Australian Dementia Forum |
|---|---|
| Country/Territory | Australia |
| City | Brisbane |
| Period | 1/05/16 → 3/05/16 |