Bridging the gap betweenpractice & researchLizette Wattel UNO-VUmc

• Dutch nursing homes,

• Why nursing homes participate in our network;

• The organisation of our network

• Examples of research(projects)

• Benefits and difficulties?

Nursing homes in The Netherlands

• Long Term Care– Factors in assessment:

– Social life skills ↓ ↓– Psychosocial /cognitive functions ↓ ↓– ADL ↓/ ↓ ↓– Mobility ↓/ ↓ ↓– Challenging behaviour– Structural care need, several times a day

• Geriatric Rehabilitation

• Home care

Why do organisations choose to participate in the UNO-VUmc?• improve the quality of care,

• advance the field,

• improve the reputation of the organization as a center of

excellence,

• improve recruitment and retention of (exceptional) staff,

• establish ties with the university.

The bottom-up approach

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all fallers (n=63)

frequent fallers(n=35)

all participants(n=100)

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all fallers (n=55)

frequent fallers(n=29)

all participants(n=86)

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intervention

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What we do

• Research• Education• Development of best practices• Implementation

• Short term vs. long term results• Development vs. implementation

good care for people with brain diseases

good rehabilitation care

good organisation of care

Assistive technologyin care for people with brain diseases

Care for Stroke in LTC in NL

Conclusions

Irritability, depressive symptoms and apathy occur as the most frequent neuropsychiatric symptoms.

Almost 60% of the residents is in pain, despite treatment.

Nearly half of the residents has moderate or severecognitive impairment.

More than a quarter of the residents has poor expressive abilities.

Almost a third of the residents has a low social engagement.

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Conclusions

Irritability, depressive symptoms and apathy occur as the most frequent neuropsychiatric symptoms.

Almost 60% of the residents is in pain, despite treatment.

Nearly half of the residents has moderate or severecognitive impairment.

More than a quarter of the residents has poor expressive abilities.

Almost a third of the residents has a low social engagement.

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Apathy & Pain

Apathy • 28% of residents. • related to

– cognitive impairment – very severe ADL-dependency – being >12 hours per day in bed

• not related to depressive mood symptoms

(individualized) stimulating activities?

Substantial pain• 28% of residents. • related to

– a 60% increase in NPIQ score – clinically relevant symptoms of

delusions, agitation/aggression, depression, and anxiety

• associated with low social engagement

Pain management!!

Benefits for research & practice• For research:

– New ideas– Better research plan– Easier access to care organisations– Attention to results

• For practice:– Quick and easy access to results– Useful results, suitable for improving quality of care– Inspiring for professionals– Influence on research– Help and advice for small research projects– Supported implementation– Development of more professional climate

Difficulties for practice

• Time

• Achieving results in large organisations

• Embedding research & innovation

• Support by management

• Implementation = changing = difficult

• Changes in personnel

Research & practice