The following are projects which have been funded and successfully completed by
the Texas Long Term Care Institute:
| The Practitioner's Guide to Culturally Sensitive
Practice for Death & Dying |
| Merri Cohoe, BSW
Sue Ellen Contreras, BSW Dede L. Sparks, BSW This project produced a practitioner's manual for increasing religious sensitivity for health care professionals during end-of-life situations. The manual is available to social workers, physicians, nurses, chaplains, long term care facility administrators, and hospice personnel. In many situations, culturally and religiously insensitive practice is the result of being uninformed, not from being unconcerned. This manual is a valuable resource for all professionals working in the health care field. |
| A Focus Group Study of Perceptions of Quality of Care Among Nursing Assistants |
| George C. Burke III, Dr. P.H.
Jim Summers, PhD Quality in long term care is typically measured by customer perceptions. Most often, customers represent elders, families, and external stockholders. Studies, however, have neglected one important component: staff perceptions. This research project sought to define quality from the perspective of staff members currently working in long term care facilities. Qualitative data in the form of open-ended questions were gathered from certified nurse aides through the use of focus groups. |
| Impact of the Eden Alternative on Texas Nursing Home Residents'
Quality of Life:A Psychosocial Perspective |
| Mr. Rich Wyllie, LMSW Studies regarding the Eden Alternative offer promising results. However, the indicators under scrutiny assess medical and administrative issues. This was the first study in the nation to view elders' quality of life from a psychosocial perspective. During the in-depth study, nursing home elders, staff members, and families were interviewed using a survey designed to evaluate the psychosocial quality of resident life. Interviews took place every six months over a two-year period of time and results were compared and contrasted with results obtained concurrently from control facilities. |
| The Eden Alternative: The Texas Project |
| Conducted by the Institute and Sandy Ransom with oversight by the Texas Eden Alternative Task Force The Institute initiated the Texas Eden Alternative Research Project in the summer of 1995. Six facilities participated in the project. Resident animals, plants, daily interaction between elders and children, team management, validation therapy, and family friendly personnel policies form the components of the Texas project. These six facilities, through embodiment of the Eden principles, serve as models for others interested in learning about the concept. A drop in the number of anti-psychotic medication given elders; decreased antidepressant use; and reduced in-house pressure sores was observed during the research. |
| Alzheimer's Disease Education Program |
| Ms. Julie Johnson, Executive Director This project developed an educational curriculum on dementia in partnership with the
Texas Long Term Health Care Institute, to broaden quality care techniques in Texas
and nationwide. |
| Validation Therapy Training Curriculum |
| Naomi Feil, Executive Director Ms. Feil, internationally known for the development of a theory and method of communication known as Validation Therapy, has developed a standardized curriculum and accompanying videos which will be utilized in teaching the method to professionals, paraprofessionals, and family members. |
| A Mutual Adoption Pact |
| Oren Renick, JD, MPH, FACHE Carl Dolezal, Initial Project Director Tim Marlow, Current Project Director This research project developed and implemented a collaborative, creative service excellence initiative to deliver high quality services to the elderly. Churches, a senior association, university students, community high school youth, health care practitioners, and other San Marcos organizations collaborated on services for senior citizens in the community. |
| Austin Bell Ringers Presents Bell Ringing for Seniors |
| Linda Wilson, ADC
Mr. James Wagner This was an investigation into the effect of a regular therapeutic music oriented program on the emotional, social, and physical well-being of selected elders in a care facility. Groups of elders in eight Central Texas nursing homes participated in practice sessions which concluded with a performance for families, staff, and community. Ms. Wilson and Mr. Wagner developed a training manual with an accompanying audiotape and videotape. |
| The Perceptions of Texas Nursing Home Administrators as to the Adequacy of Preparations in Key Job Responsibilities as Defined by the NAB Domains of Practice |
| Mary Anne Franklin, MSA, NFA Through a self-administered survey, the researcher answered questions about how well Texas nursing home administrators perceived they were trained for domains of practice. It established a relationship between administrators’ opinions and their education levels. |
| Quality Long Term Care: The Role of the Volunteer Ombudsmen |
| Sharon K. Ostwald, PhD, RN This study developed a better understanding of the volunteer ombudsmen's training and experiences. It identified barriers to volunteer effectiveness and an understanding of their ongoing educational and support needs. Two separate monographs are available; one monograph deals with focus groups that were conducted and the other monograph deals with a survey of Texas nursing home ombudsmen. |
| Evaluation of the Effectiveness of a Computer-Based Communication System in Enhancing the Communicative Abilities of Individuals with Severe Aphasia |
| Rajinder Koul, PhD This demonstration study was designed to provide aphasic nursing home elders with an alternate means of communication. Elders were trained in the use of vocabulary symbols with a computer. The software program was designed to offer representational graphic (pictorial) symbols in conjunction with synthetic voice output to non-speaking individuals. Overall, the study revealed that individuals with severe aphasia were capable of learning the skills required to produce simple sentences. |
| World of Wisdom: Age of Innocence - An Intergenerational
Exchange Program |
| Oren Renick, JD, MPH, FACHE Sue Williams, PhD A year long program between Texas State's Child Development Center and The Arboretum of San Marcos involved visitation on a weekly basis between preschool children and institutionalized elderly. The child and nursing home elders took field trips, visited with each other in the nursing home, and worked on projects together. |
| The Impact of a Unit Clerk on Nurse Effectiveness in a
Long Term Care Facility |
| Sandy Ransom, RN, MSHP The Institute provided funding for placement of a ward clerk at a busy nurses' station in a 120 bed long term care facility. The study was undertaken to determine if utilization of a ward clerk would effectively allow more elder contact for the nurses and nursing assistants. The results were published in Provider, a journal of the American Health Care Association. Guidelines for Nursing Home Social Workers |
| John S. McNeil, DSW
Ann Wolens Based on a critical need for training of social workers geared specifically to nursing home practice, Dr. McNeil compiled a text authored by social work practitioners and educators. Topics include bio-psychosocial changes in aging, the role of the social workers in nursing homes, regulatory issues, measurement of cognitive impairment, ethical decision-making, and end-of-life issues. The text has been advertised in the National Association of Social Workers newsletter and is one of the Institute’s best selling monographs. |
| Geriatric Social Work Education in Texas |
| Yvette Murray, PhD Federal regulations (OBRA 1987) mandate the presence of social workers in nursing homes. This venture was undertaken to evaluate gerontological educational offerings within the field of social work in Texas institutions of higher learning. It also addresses the educational experience and needs of social workers practicing in the field. Dr. Murray presented the findings from the project to the Annual National Conference of the Bachelor's in Social Work Program Directors. |
| Needs Assessment: Regulatory, Service and Consumer Needs of the Long Term Care Industry |
| Marian Upchurch, PhD
Beth Knox, EdD Surveys were provided to a random sample of consumers, regulators, administrators, and
directors of nursing of Texas nursing homes. Data on needs assessment were analyzed and a final report was completed. |
| The Effect of Validation Therapy Training on Satisfaction with Communication and Quality of Relationship Between Staff and Family Caregivers and Demented Residents in Long Term Care |
| Robert Canon, MSW Staff in five nursing homes and family members of nursing home elders were trained in Validation Therapy techniques. The techniques were utilized with numerous communication dementia elders. Impact on elders and on the caregivers was measured. |
| A Profile of Nursing Assistants Employed in Central Texas Nursing Home |
| Sandy Ransom, RN, MSHP
Nancy Fox, BAAS
As a first step in addressing the problem of turnover among nursing assistants in Texas, a pilot study was undertaken in Central Texas. Questionnaires were mailed to all nursing homes in a 12 county area. The most significant finding discovered while coding and analyzing the data is that the people who are providing the basic care for nursing home elders are working in long term care facilities because they love their clients. In spite of many barriers, the nursing assistants who responded are working in nursing homes because that is where they want to be. |
