The aim of the study was to describe nursing home residents' health, falls, nutrition, pressure sores and quality of care as perceived by the family members and to compare these factors and prescribed drugs to the residents' degree of confusion. Two hundred and thirty-two family members of residents in ten Swedish nursing homes participated in the study (response rate 70%). The family members responded a questionnaire including background variables, health, nutrition pressure sore, and quality of care variables. Data on drug prescribing was obtained from the medical records. The findings revealed a high frequency of confused residents as perceived by the family members. Fall incidences were found in approximately 24% of the residents, pressure sores in 8% and deterioration in nutrition status in 17%. Residents rated as often confused showed significant less scores concerning physical health, psychological well-being and quality of care variables focusing on information, being respected, satisfaction with rehabilitation and meaningful occupation. A suggestion for improving the quality of care is to develop a more individual care based on knowledge of the individual person where the family members could be a fairly reliable source. Other suggestion for improving the quality of care is to give more sufficient information to the family members.
National Board of Health and Welfare (2001). Äldre-vård och omsorg. Statistik 2001:3. Socialstyrelsen, Stockholm. (in Swedish).
2.
FriesB. E.MorrisJ. N.SkaupskiK. A.BlaumC. S.GeleckiA.F. & RibbeM. (2000). Accelerated dysfunction among the very oldest — old in nursing homes. Journal of Gerontology. Series A, 55, 336–341.
3.
TariotP.N.PodgorskiC. A.BlazinaL. & LeiboviciA. (1993). Mental disorders in the nursing homes: Another perspective. American Journal of Psychiatry, 150 (7), 1063–1069.
4.
GustafssonL. (1996). What is dementia?Acta Neurologica Scandinavia. Supplement168, 22–24.
5.
FrancisJ. MD. (1992). Delirium in elderly patients. American Geriatric Society, 40, 829–838.
6.
American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders. DSM-IV (4th ed). Washington, DC.
7.
NeelonV. J. & ChampagneM. (1992). Managing cognitive impairment: The current bases for practice. In FunkE.QuistM. T.ChampagneM. T. & WieseR. A. (eds). Key aspects of elderly care. Managing falls, incontinence and cognitive impairment. Springer, New York, 239–250.
8.
LuwichR. & O'ToleA. N. (1996). The confused patients. Nurses knowledge and interventions. Journal of Gerontological Nursing, 22 (1), 44–49.
9.
SchorJ.D.LevkoffS.E. & LipsitsL.A. (1992). Risk factors for delirium in hospitalized elderly. JAMA, 267, 827–831.
10.
JohanssonI (1998). Quality of care and assessment of health among elderly in acute care. Doctoral dissertation. Linköping university, Linköping
11.
ForemanM. D.WakefieldB.CulpK. & MilisenK. (2001). Delirium in elderly patients: An overview of the state of the science. Journal of Gerontological Nursing, 27 (4), 12–20.
12.
LipowskiA. J. (1992). Update on delirium. Psychiatric Clinics in North America, 15, 335–346.
13.
SchmidtI. & FastbornJ. (2000). Quality of drug use in Swedish nursing homes. A follow-up study. Clinical Drug Investigation, 20, 433–446.
14.
ElmståhlS.PerssonM.AndrenM. & BlabolieV. (1997). Malnutrition in geriatric patients: A neglected problem. Journal of Advanced Nursing, 26, 851–855.
15.
ChristenssonL.UnossonM. & EkA-C. (1999). Malnutrition in elderly people newly admitted to a community resident home. The Journal of Nutrition, Health and Aging, 3, 133–139.
16.
SidenvallB.FjellströmC. & EkAC. (1996). Elderly patients meal patterns- a retrospective study. Journal of Human Nutrition and Dietetics, 9, 263–272.
17.
Lundin-OlssonL. (2000). Prediction and prevention of falls among elderly people in residential care. Doctoral dissertation, Umeå University, Umeå.
18.
UdénG.EnhnforsM. & SjöströmK. (1999). Using the initial risk assessment and recording as the main nursing intervention in identifying risk of falls. Journal of Advanced Nursing, 29, (1), 145–152.
19.
Hill-WestmorelandE.E.SoekenK. & SpellbringAM. (2002). A meta-analysis of fall prevention programs for the elderly. How effective are they?Nursing Research, 51 (1), 1–8.
20.
LyneP. A.PapanikolouP. & LycettE. (2000). An empirical investigation of pressure ulcer risk factors. Nursing Standards, 14 (49), 46–50.
21.
EkA-C. (1987). Prevention, treatment and healing of pressure sores in long-term care patients. Scandinavian Journal of Caring Sciences, 1, 7–13.
22.
BoursG.HalfensR.M.LubbersM. & HaalboomH. (1999). The development of a national registration form to measure the prevalence of pressure ulcers in the Netherlands. Ostomy/Wound Manage, 45, 28–40.
23.
EdbergA-K. (1999). The nurse-patient encounter and the patients' state: Effects of individual care and clinical group supervision in dementia care. Doctoral dissertation. The Centre of Caring Sciences and Department of Psycho geriatrics and Clinical Neuroscience, Lund University.
24.
WildeBStarrinB.LarssonG. & LarssonM. (1993). Quality of care from a patient perspective. A grounded theory study. Scandinavian Journal of Caring Sciences, 7, 113–120.
25.
FinnemaE.de LangeJ.DroesR. M.RibbeM. & van TilburgW. (2001). The quality of nursing home care: Do the options of family members change after implementation of emotion-oriented care. Journal of Advanced Nursing, 35 (5), 728–740.
26.
SOU (1997:51). Brister i omsorg — en fråga om bemötande av äldre. Delbetänkande av utredningen om bemötande av äldre. Socialdepartementet, Stockholm. (in Swedish).
27.
LarssonWilde B.ScmidtI.Hall-LordM.L. & JohanssonI. (2001). Psychotropic drugs related to family members perception of quality of care among elderly people living in nursing homes. Journal of Social and Administrative Pharmacy, 18 (2), 67–74.
28.
SchmidtI. (2000). Communication and teamwork-studies of the impact on quality of drugs use in Swedish nursing homes. Doctoral dissertation, Uppsala University.
29.
LarssonJ.UnossonM.EkA-C.NilssonL.ThorslundS. & BjurulfP. (1990). Effect of dietary supplement on nutritional status and clinical outcome in 501 geriatric patient — a randomised study. Clinical Nutrition, 9, 179–184.
30.
WHO Collaborating Centre for Drug Statistics methodology (1998). ATC Classification and DDD assignment. WHO Collaborating Centre for Drug and Statistics Methodology, Oslo.
31.
LarssonG.LarssonWilde B. & MunckI. E. (1998). Refinement of the questionnaire Quality from the Patient's Perspective using structural equation modelling. Scandinavian Journal of Caring Sciences, 12, 111–118.
32.
AltmanD.G. (1991). Practical statistical for medical research. Chapman & Hall, London.
33.
Sykepleiernas Samarbete i Norden (SSN) (1987). Etiska retningslinjer for sykepleieforskning i Norden. Århus-stiftsbogtrykkeri, Danmark. (in Danish).
34.
MilisenK.ForemanM. D.GodderisJ.AbrahmI.L.BroosP.L.O. (1998). Delirium in the hospitalised elderly: Nursing assessment and management. Nursing Clinics of North America, 33, (3), 417–439.
35.
OlinÖdlund A.ÖsterbergP.HådellK.ArmyrI.JerströmS. & LjungquistO. (1996). Energy-enriched hospital food to improve energy intake in elderly patients. Journal of Enteral and Parenteral Nutrition, 20, 93–97.
36.
GunningbergL.LindholmC.CarlssonM., & SjödenP-O. (2001). Risk, prevention and treatment of pressure ulcers — nursing staff knowledge and documentation. Scandinavian Journal of Caring Sciences, 15, 257–263.
37.
BussI.HalfensR.Abu-SaasHuyer H. & KokG. (1999). Evidence — based nursing pratice. Both state of the art in general and specific to pressure sores. Journal of Professional Nursing, 15, 73–83.
38.
HertzbergA., & EkmanS-L. (2000). We, not them and us? Views on the relationship and interactions between staff and relatives of older people permanently living in nursing homes. Journal of Advanced Nursing, 31 (3), 614–622.
39.
Cohen-MansfieldJ.WernerP.WeinfieldM.BraunJ.KraftG.GerberB. & WillensS. (1995). Autonomy for nursing home residents: The role of regulations. Behavioural Sciences and the Law, 13, 415–423.
40.
Magaziner (1988). Patients-proxy response comparability on measures of patients health and functional status. Journal of Clinical Epidemiology, 1, 1065–74.
41.
AbbeyA.SchniederJ. & MozelyC. (1999). Visitors views on residential homes. British Journal of Social Work, 29, 567–579.
42.
WildeB.LarssonG.LarssonM. & StarrinB. (1995). Quality of care from the elderly person's perspective: Subjective importance and perceived reality. Aging Clinical and Experimental Research, 7, 140–149.
