MHL research briefings on the 8 best practice themes

Overall, research on maintaining identity seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• Psychosocial interventions help staff seeing beyond the disease (Lawrence et al 2012).
• A clearer evidence base that supports the use of reminiscence therapy/psychosocial interventions in a range of care setting to improve quality of life and improve symptoms of loneliness, anxiety and depression (Huang et al., 2015; Bohlmeijer et al., 2007).
• No adverse effects reported from reminiscence therapy and clear support to recommend this intervention (Elias et al., 2015). Life story is a particularly importance psychosocial intervention in improving quality of life in care homes (Bohlmeijer et al., 2007).
• A clearer evidence base to support participatory arts activities enhancing person-centred approaches to care (Fraser et al., 2014).
• There is a need to focus on psychosocial needs as well as physical needs in individuals with dementia (Cadieux et al., 2016).

Overall, research on sharing decision making seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• The types of decisions (resident dominant and resident subordinate) (Arendts et al., 2013)
• The use of decision aids in proxy decisionmaking (Lord et al., 2015)
• The type of information residents and families want in order to make decisions (Turnpenny and Beadle-Brown, 2015).
• Care conferencing rather than simply MDT involvement (Philips et al., 2013).

Overall, research on creating community seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• Resident concerns about lack of autonomy and difficulty in forming appropriate relationships (Bradshaw et al.,2012).
• Social interaction, connection and engagement has a positive impact on health and wellbeing for older people in long term care (Cooney et al., 2014).
• Several interventions developed to enhance meal time experience of residents to improve health and nutrition and also quality of life (Vucea et al., 2014; Green et al., 2010).
• The interpretation of ‘at home’ informs ongoing clinical practice and theory development focused on shaping environments for healing and enabling experiences of home during residential transition (Molony, 2010).
• Supporting residents (if they wish) to become involved in community and/or intergenerational activities (Ciprani, 2007)

Overall, research on facilitating transitions seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• The level of involvement and choice a resident has in the decision-making process plays a significant role in whether they will successfully adapt to life in a care home (Chao et al., 2008; Johnson et al., 2010; Fraher and Coffey 2011; Lee et al., 2012; Brownie et al., 2014; James et al., 2014)
• Individuals who do not have a choice in care home admission experience higher levels of sadness, depression and anger compared to those individuals who do have choice about the move (Brownie et al., 2014). Additionally, if a care home admission is unplanned and the placement is not discussed with the resident, this can lead to feelings of loneliness and isolation (Thein et al., 2011; Brownie et al., 2014; Bowers, et al., 2015)
• Families find it difficult to adjust to being a visitor as opposed to being the primary carer and feel unaware of expectations (Ryan and McKenna, 2013). Moreover, they feel unprepared and unsupported for the role transition (Eika et al., 2014).
• Many research studies report that care home environments can be restrictive with lack of privacy, reduced social interaction, and regimented routines. Residents experience a loss of autonomy, independence and identity making
  adjustment to life in a care more challenging (Tsai H-H and Tsai Y-F 2008; Cooney 2011; Bradshaw 2012; Ericson-Lidman et al., 2015; Krizaj et al., 2016)
• The importance of a positive supportive relationship between staff and families is reiterated within the literature (Koplow et al., 2015). Moreover, familiarity with the care home and care staff can establish a relationship of trust and is seen as a reassuring factor for the individual, and their family (Ryan and McKenna ,2013).

Overall, research on improving health and healthcare seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• The health and health care needs of care home residents is increasingly complex (Le Reste et al., 2013);
• Oral health issues have garnered increased attention as a quality of life and quality of care need in this population (Hoben et al., 2017; Wang, Huang, Chou, & Yu, 2015);
• Diabetes management continues to be a significant challenge for care home residents (Garcia & Brown, 2011; Sinclair, 2011)
• As a function of the limited medical service available to many care home residents and complex care needs, transfer to Emergency Departments is often the most expeditious way to ensure medical care (Dwyer, Stoelwinder, Gabbe,
  & Lowthian, 2015);
• Whilst there is a lack of robust research on which to evaluate interventions for managing the health needs of care home residents, an individualized approach appears most efficacious (e.g., Jutkowitz et al., 2016).

Overall, research on supporting good end-oflife seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• There remains insufficient data related to resident outcomes for end of life care (Hall et al.,2014; Parker and Hodgkinson, 2011).
• Family members may have an expectation that highly skilled medical professionals should be more involved in end of life care (Fosse et al., 2014).
• During end of life care, residents reported a desire to remain connected to their previous life roles (Carlson, 2007).

Overall, research on developing the workforce seems to reflect many of the findings of the original review (NCHRD, 2007).

Post 2007, new evidence suggests:

• Evidence on training to improve staff members’ communication skills (Eggenberger et al., 2013; Vasse et al., 2010; Spector et al., 2013; McGilton et al., 2009).
• Studies looking at factors that affect recruitment, retention and burnout for staff (Westermann et al., 2014; Chenoweth et al., 2010; Jeon et al., 2010).
• Studies on staff making a positive difference (Donald et al., 2013; Levy-Storms 2008)
• Studies on abuse and restraint (Ayalon et al., 2016; Moehler et al., 2012).
• Studies looking at the impact of teaching physical skills (Weening-Verbree, 2013; Taylor et al., 2011).
• Studies suggesting that staff training is not evidence based (Fossey et al., 2014)

Overall, research on promoting a positive culture seems to reflect many of the findings of the original review (NCHRD, 2007). Post 2007, new evidence suggests:

• Staffing and skill mix can help to promote a positive culture in care homes (Shin and Bae, 2012).
• Team work and team approaches can enhance job satisfaction (Pol-Grevelink et al., 2012).
• Interventions aimed at enhancing positive culture can be beneficial (Petriwskyj et al., 2015; Andre et al., 2014; Hill et al., 2011).