Group 5

TOPIC

A Critique on Predictors of Care

Dependency in Nursing Home residents
with Moderate to Severe Dementia
 Introduction

 The purpose of the paper is intend to critique the research article titled “Predictors of care
dependency in Nursing Home Residents with moderate to Severe Dementia” by
Henskens M, Nauta IM, Drost KT, Milders MV and Scherder EJA(2019). The paper
will be discussing the problems of the study, reasons of the problem, theoretical
framework and literature review, the issues with the methodology used, results
presentation and the research findings discussion.
 Research problem

 In their research Henskens M, Nauta IM, Drost KT, Milders MV and Scherder EJA(2019) identified people
or individuals who are prone to dementia and who struggles with the Activities Daily Living (ADL).
They also identified dementia as being the disease older people especially living in care or nursing
homes are being the victim of dementia and that it impacts their Activities Daily Living (ADL).
 The study identified care giving as a contributor to the Activities Day Living of older people. They state that
the abilities of people living with dementia is largely dependent on the care being provided to the
people living with dementia, such that the better the care the better, improved ADL to people living with
dementia. If this revelation is made well informed to the those providing working in care and nursing
homes providing care to elderly people especially living with dementia would make a huge impact to
elderly lives.
 This study intended to identify what causes poor activities daily living and the solution to improve the
activities daily living of the elderly. The intervention identified in this research state that elderly people
be encouraged to take part in exercise that help to reflect their muscles such as taking walks, doing yoga
and other exercises that would help them reflects their muscles in their body. This study seems to have
opened opportunities for further study as what have been identified and suggested is easily
implementable by caregivers or relatives

 Literature Review

 Several studies on Activities Daily Activities in nursing and care homes have been carried. (Williams
BC, 1994) in their research found out that among nursing homes, limitations in Activities Daily
Living (ADLs) are the strongest determinants of the nursing resources (how much it cost to
provide nursing care). They outlined the example ADL limitations play a central role in all case
mix classification system that predict nursing resource use in nursing homes.
 Activities of daily living (ADL) comprise of the basis actions which involve providing care for one’s
self and body, include personal care, mobility and eating/drinking as defined by (Mlinac & Feng,
2016).
 As stated in the article older people are more likely to be victims of dementia which affects their daily
life activities. The study shows that as people advances to the age group of 85 years and older,
most of the would have advanced in dementia. As the article stated that people with dementia
have their activities of daily living, dementia always impairs memory and insights. People with
dementia will present with cognitive complaints and sometimes are painfully aware of their
intellectual deterioration (Mendez MF, 2003).
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 Literature Review

 People with dementia maybe able to manage some normal activities, i.e. getting dressed
or eating.
 In some circumstances they may lose their abilities of solving problems or controlling
their emotions such that may even become agitated or perceive things that are not
even there.
 As stated in the article that an increase in care dependency is closely related to the
development of dementia and other health related diseases. Care is an important
component especially in care homes of the long term system for people with
dementia. Studies currently show that around one-third to one-half of people with
dementia in high income countries and 6% of those in low- and middle-income
countries are cared for in cared homes (ReportWorldAlzheimer, 2013).

 Literature Review

 Some studies in their research state that chronic conditions such as dementia will likely
lead to care dependency and nursing care problems which leads to the nursing home
admission.
 Studies show that progression and consequential nursing care problems in care
dependency have been identified as common reasons why people relocate to a nursing
home. In this situation, frequent issues include pressure ulcers, incontinence, falls,
malnutrition and restraints. In this case a lot of nursing homes today monitor their
quality of care to stabilise or improve care dependency and/or nursing care problems
for residents and to avoid negative consequences like reduced quality of life, life
health care costs and mortality.

 Theory framework

 Values and philosophy are essential as they form the foundation for the whole person centred
dementia care conceptual framework. Everyone has his or her meaning of life,
authencity personality, spirit, character, history and interests, preferences and need to
continue experience life at all stages of dementia. The person is not their dementia
illness rather the condition is only one aspect of their current being. It is important to
focus on the strength of the person living with dementia rather than on diminished or lost
abilities. It is important to enter the world of the person living with dementia to better
understood communicate with and interpret the meaning of his or her behavioural
expressions from their perspective.
 Without a common understanding and framework for person centred dementia care, poor
dementia care practices including overusing of anti-psychotic medications would persist.
 Research Question (Hypothesis)

 As stated from the article the framework of the study was generated from other studies
carried out by other researchers such as Martyr and Clare (2005), stating the
predictors of care dependency in care and nursing homes. The framework was
compared with that of Schussler & Lohrmann (2005), and discrepancy between the
framework and variable was questions variables. The framework refers to poor caring
and dementia as a result of care dependency in homes and nursing homes that impacts
the Activities Daily living (ADL) of elderly people. This study does not specifically
list down the specific causes of increase in care dependency but rather discusses the
diseases and type of welfare that impacts the Activity Daily Living (ADL).
 References

 Sekaran, U. & Bougie, R., 2016. Advantages and Disadvantages of observation. In: Research
methods for business, Skill building appraoch. London: Wiley & sons.
 Williams BC, F. B. F. J. S. D. a. G. M., 1994. Activities of Daily Living and Costs n Nursing
Home. Health Care Finance , pp. 117 - 135.
 Devkota, B., 2019. Mathstopia. [Online].
 Mendez MF, a. C. J., 2003. Dementia. London: Butterworth.
 Mlinac, M. & Feng, M., 2016. Assessment of Activities of Daily Living, Self-Care and
Independence. Clinical Neuropsychology, 6 September, pp. 506 - 516.
 ReportWorldAlzheimer, 2013. An analysis of long-term care for dementia. Alzheimer's Disease
International.
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