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Relationship-Based Care and Behaviours of Residents in Long-Term Care Facilities

DOI: 10.1155/2014/949180

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Abstract:

Introduction. In long-term care (LTC), person-centred approaches are encouraged. One such approach, relationship-based care (RBC), aims among other things to reduce residents’ agitated behaviours. RBC has been used in numerous Quebec LTC facilities over the past decade but it has never been studied. Objective. Explore correlations between use of RBC by trained caregivers and the frequency of agitated and positive behaviours of residents with cognitive impairments. Methods. Two independent raters observed fourteen caregiver/resident dyads in two LTC facilities during assistance with hygiene and dressing. Checklists were used to quantify caregivers’ RBC use and residents’ agitated and positive behaviours. Results. Scores for RBC use were high, suggesting good application of the approach by caregivers. Correlation analyses showed that offering residents realistic choices and talking to them during care were associated with both positive and agitated behaviours ( from 0.03 to 0.003). However, many other components of RBC were not associated with residents’ behaviours during care. Conclusions. There were only a few quantitative links between the RBC checklist items and the frequency of agitated or positive behaviours. Other studies with a more rigorous research design are needed to better understand the impact of relationship-based care on residents’ behaviours. 1. Introduction 1.1. Person-Centred Care: Foundations, Implementation, and Effects In Quebec, the mission of residential long-term care (LTC) centres is to provide quality care to clients who are severely impaired physically and especially cognitively [1]. Because of cognitive impairments, residents in these centres frequently display problem behaviours [2–4]. These behaviours affect not only the well-being of their formal caregivers (e.g., long-term care staff) [5–7] but also the residents’ own quality of life [8]. To meet the needs of clients who present problem or agitated behaviours, new approaches have been developed over the years. Person-centred care is designed to be an alternative to or to complement pharmacotherapy in reducing problem behaviours in individuals with dementia [9]. According to the Committee on Quality of Health Care in America, person-centred care is one of the main areas for improvement that the health care system should address in order to increase the quality of health care, especially long-term care [10]. Such approaches are based on a humanistic concept of health care, where the primary focus must be on the person and his/her life experience and capacities, rather than

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