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The purpose of this study was to examine changes in and predictors of perceived tangible social support over a 2-year period among older adults new to LTSS. Linear mixed effects models were used to model repeated measures of tangible social support as a function of LTSS type [NH, AL, HCBS], personal, clinical, and health-related quality of life variables. AL residents reported greater initial tangible social support, but NH and HCBS residents improved more over time. Predictors of increased tangible social support over time included greater positive affect, sense of aesthetics, education, satisfaction with family relationships, and total number of close friends and family. Decreased tangible support over time was associated with greater depressive symptoms. Findings indicate the positive influence of NH and HCBS services on perception of tangible social support, and the importance of addressing depressive symptoms and assisting with the maintenance of important relationships. [ABSTRACT FROM AUTHOR]

Demand for home and community-based services continues to outpace employment of home care workers (HCWs) who provide this vital assistance. HCWs face challenges that contribute to inadequate staff retention. Of particular concern is the lack of research on HCWs' emotional health. This research describes facilitators and resources that support HCW emotional health. Qualitative descriptive interviews were conducted with a purposive sample of HCWs (n = 17) who were formally recognized for their success. Interviews were audio recorded, transcribed verbatim, and coded in Dedoose. Thematic analysis revealed three facilitators of emotional health that HCWs link to their professional success: "right state of mind," practicing self-care, and a combined sense of appreciation and support. HCWs highlight specific, practicable resources that promote their emotional health. Policy implications connects low wages and benefits to HCW emotional health, and practice implications for enhancing training and support to retain these important workers. [ABSTRACT FROM AUTHOR]

Background: Nursing homes (NHs) are required to provide person-centered care, efforts often folded into broader culture change initiatives. Despite the known benefits of culture change, it is difficult to measure. This study aims to assess the criterion validity of the Preferences for Everyday Living Inventory (PELI) Implementation Indicator with other culture change measures. Methods: Using data from Ohio-based NHs (n = 771), logistic regression techniques demonstrated the relationship between the PELI Implementation Indicator and two validated culture change measures, the Resident Preferences for Care (RPC) and Certified Nursing Assistant (CNA) Empowerment scales. Results: There was a significant relationship between the two scales and complete PELI implementation holding all other variables constant. The RPC and CNA Empowerment scales were significantly associated with complete PELI implementation. Discussion: Findings suggest that the PELI Implementation Indicator can be used as a pragmatic indicator of a community's adoption of person-centered care and culture change. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study was to examine the relationship between high wages and empowerment practices on certified nursing assistant (CNA) retention, necessary for providing high-quality care for nursing home (NH) residents. Methods: Measures of provider-level CNA empowerment and wages from the 2015 Ohio Biennial Survey were used to estimate two regression models on retention (n = 719), one without and one with an interaction term of high wages and high empowerment. Results: Only in the context of the interacted model were NHs that provided both high wages and high empowerment associated with a 7.09 percentage-point improvement in the CNA retention rate (p =.0003). Individually, high wages and a high empowerment score were not statistically significant in either regression model. Discussion: Retaining CNAs in NH communities requires a combination of empowerment practices (e.g., involving CNAs in decision-making about hiring other staff) and high hourly wages. [ABSTRACT FROM AUTHOR]

In recent years, Ohio nursing homes (NHs) have received an increasing number of complaints. The current study aims to gain a better understanding of the relationship between NH organizational characteristics and the number of complaints. Secondary data analysis was used. Four data sources on Ohio NHs were merged. Ohio NH complaints data reported in 2018 and 2019 was linked with the 2017 Ohio Biennial Survey of Long-Term Care Facilities, 2017 Ohio Nursing Home Resident Satisfaction Survey, and 2018 Ohio Nursing Home Family Satisfaction Survey. Descriptive analysis, bivariate tests (ie, analysis of variance and χ2 test), and multinomial logistic regression analyses were conducted. Findings included that urban location, NH administrator (NHA) and director of nursing (DON) turnover in the previous 3 years, NH size, occupancy rate, certified nursing assistant (CNA) retention, and overall family satisfaction were significantly associated with total complaints. NHA and DON turnover, NH size, CNA retention, and overall family satisfaction were found to be significantly associated with substantiated complaints. The importance of leadership (ie, NHA and DON) turnover, CNA retention, and family satisfaction indicates that specifically targeted efforts to improve in these areas can have a positive impact on NH quality. [ABSTRACT FROM AUTHOR]

Objectives Although assessing individual consumer preferences are an important first step in providing person-centered care, the purpose of this study was to identify the top 10 shared preferences that are important to a majority of consumers receiving long-term services and supports. Design A cross-sectional survey design was used. Setting and participants Preference assessment interviews were conducted with 255 nursing home (NH) residents and 528 older adults receiving home and community-based services (HCBS). Measurements The Preferences for Everyday Living Inventory (PELI) was used to collect consumer preference information. Two versions of the PELI were used—the PELI-NH for NH residents and the PELI-HC for clients receiving HCBS and analysis focused on 41 shared items between the 2 versions. All respondents answered PELI questions independently and rated the importance of psychosocial preference items on a scale from not at all to a lot/very important. Results Ten preferences were shared as being important or very important by NH residents and older adults receiving HCBS. Most notably, more than 90% of respondents in each group rated “having regular contact with family” as an important priority. Having privacy, choices about what to eat, when to bathe, and activity options also were important preferences for a majority (77%-93%) in both settings. Conclusion Providers seeking to incorporate preference-based care can utilize study results as a foundation to incorporating important preferences into the care delivery process at the organizational level across care settings. For example, assessing all consumers on this core set of 10 shared preferences can assist with relationship building, transitions in care, and quality improvement. However, preferences with aggregate low-rated levels of importance in this study should not be discredited or eliminated. It is important for providers to understand the unique preference inventory of each older adult, which can then be targeted toward meeting goals for preference fulfillment. This can aid in bringing preferences into practice to improve the quality of care and quality of life to best meet the psychosocial needs of each person. [ABSTRACT FROM AUTHOR]

Objectives: This article examines the natural history of changes in emotional status as measured through emotional well-being and depressive symptoms over a two-year period among older adults new to long-term services and supports (LTSS). Method: In-person interviews were conducted with 470 older adults within sixty days of entry into LTSS and then quarterly through twenty-four months. Results: Multivariate generalized estimating equation models indicate improvements in emotional status, with depressive symptoms decreasing and overall emotional wellbeing improving. Independent predictors of depressive symptoms and emotional well-being are described. Discussion: Older adults who have transitioned to LTSS experience changes in emotional status over time. Significant contributors to emotional status are identified that can be addressed and supported through LTSS programs. [ABSTRACT FROM AUTHOR]