Age and Ageing collection: Care Homes

The collection outlines the technical issues that researchers face, by grouping together important feasibility trials conducted in the sector.  It looks at the challenges of measuring quality of life and working with routine data in care homes. It brings together observational studies considering loneliness, functional dependency, stroke outcomes, prescribing and acute deterioration. Health services research in care homes is represented by two studies that demonstrate realist evaluation as a way to make sense of service innovations.

Papers are included that consider: non-pharmacological strategies for residents with dementia, end-of-life care, sexuality and intimacy, and the care home workforce.  Given the importance of the COVID-19 pandemic in care homes, all of the care home COVID-19 papers published in Age and Ageing to date are included.

Finally, a group of papers that present innovative approaches to research in care homes, each of which gives voice to residents and/or staff, are collated and presented as a way of moving towards a more resident- and care home-centred research agenda.

- Adam L Gordon, Chloe Bennett, Claire Goodman, Wilco P Achterberg

The commentary

We have written a commentary to accompany this collection, Making progress: but a way to go—the age and ageing care-home collection, published on the Age and Ageing journal website

The collection

Feasibility Randomized Controlled Trials in Care Homes

• The PiTSTOP study: a feasibility cluster randomized trial of delirium prevention in care homes for older people. Siddiqi N, Cheater F, Collinson M, et al.
• A posture and mobility training package for care home staff: results of a cluster randomised controlled feasibility trial (the PATCH trial). Graham L, Ellwood A, Hull K, et al.
• An intervention to increase physical activity in care home residents: results of a cluster-randomised, controlled feasibility trial (the REACH trial). Forster A, Airlie J, Ellwood A, et al.

Measuring Quality of Life in Care Home Residents

• Measuring health-related quality of life of care home residents: comparison of self-report with staff proxy responses. Usman A, Lewis S, Hinsliff-Smith K, et al.
• Inter-rater reliability of care home staff’s proxy judgements with residents’ assessments of their own health-related quality of life: an analysis of the PATCH trial EQ-5D data. Kelly C, Hulme C, Graham L, et al.

Routine data and care home residents

• Identifying care-home residents in routine healthcare datasets: a diagnostic test accuracy study of five methods. Burton JK, Marwick CA, Galloway J, et al.  
• Identifying who lives in a care home—a challenge to be conquered. Burton JK, Guthrie B.
• Accurate identification of hospital admissions from care homes; Development and validation of an automated algorithm. Housley G, Lewis S, Usman A, et al.
• Continuous monitoring of emergency admissions of older care home residents to hospital. Sherlaw-Johnson C, Smith P, Bardsley M.

Loneliness

• Loneliness as a risk factor for care home admission in the English Longitudinal Study of Ageing. Hanratty B, Stow D, Collingridge Moore D, et al.
• What is the prevalence of loneliness amongst older people living in residential and nursing care homes? A systematic review and meta-analysis. Gardiner C, Laud P, Heaton T, et al.

Risk factors for admissions to care home

• Do home modifications reduce care home admissions for older people? A matched control evaluation of the Care & Repair Cymru service in Wales. Hollinghurst J, Fry R, Akbari A, et al.

Changes in care home population over time

• Changes in health and functioning of care home residents over two decades: what can we learn from population-based studies? Barker RO, Hanratty B, Kingston A, et al.

Stroke outcomes in care home residents

• Survival and outcomes for stroke survivors living in care homes: a prospective cohort study. Clery A, Martin FC, Redmond P, et al.  

Prescribing in care home residents

• Antibiotic prescribing and associated diarrhoea: a prospective cohort study of care home residents. Gillespie D, Hood K, Bayer A, et al.
• The burden of psychotropic and anticholinergic medicines use in care homes: population-based analysis in 147 care homes. Grill P, Marwick C, De Souza N, et al.
• Are older patients with diabetes still being overtreated in French long-term care homes? Quilot E, Petit J-M, Vergès B, et al.

Acute deterioration in care home residents

• A prospective observational study to investigate utility of the Delirium Observational Screening Scale (DOSS) to detect delirium in care home residents. Teale EA, Munyombwe T, Schuurmans M, et al.
• Distribution of the National Early Warning Score (NEWS) in care home residents. Barker R, Stocker R, Russell S, et al.

Health services research in care homes

• Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes. Gordon AL, Goodman C, Davies SL, et al.
• How quality improvement collaboratives work to improve healthcare in care homes: a realist evaluation. Devi R, Chadborn NH, Meyer J, et al.

Non-pharmacological strategies for dementia

• The use of non-pharmacological interventions for dementia behaviours in care homes: findings from four in-depth, ethnographic case studies. Backhouse T, Killett A, Penhale B, et al.

End of life care

• Care home residents who die in hospital: exploring factors, processes and experiences. Alcorn G, Murray SA, Hockley J.

Sexuality and intimacy

• A scoping review of education and training resources supporting care home staff in facilitating residents’ sexuality, intimacy and relational needs. Horne M, Youell J, Brown LJE, et al. 

Care home workforce

• The competencies of Registered Nurses working in care homes: A modified Delphi study. Stanyon MR, Goldberg SE, Astle A, et al.
• Burnout in UK care home staff and its effect on staff turnover: MARQUE English national care home longitudinal survey. Costello H, Cooper C, Marston L, et al.
• Attracting, recruiting and retaining nurses and care workers working in care homes: the need for a nuanced understanding informed by evidence and theory. Devi R, Goodman C, Dalkin S, et al.

COVID-19 in care homes

• Commentary: COVID in care homes-challenges and dilemmas in healthcare delivery Key points. Gordon AL, Goodman C, Achterberg W, et al.
• The impact of COVID-19 on adjusted mortality risk in care homes for older adults in Wales, UK: a retrospective population-based cohort study for mortality in 2016–2020. Hollinghurst J, Lyons J, Fry R, et al.  
• Impact of COVID-19 on care-home mortality and life expectancy in Scotland. Burton JK, Reid M, Gribben C, et al.
• COVID-19 infection and attributable mortality in UK care homes: cohort study using active surveillance and electronic records (March–June 2020). Dutey-Magni PF, Williams H, Jhass A, et al
• Care-home outbreaks of COVID-19 in Scotland March to May 2020: National linked data cohort analysis. Burton JK, McMinn M, Vaughan JE, et al.
• Is Point-of-Care testing feasible and safe in care homes in England? An exploratory usability and accuracy evaluation of a Point-of-Care Polymerase Chain Reaction test for SARS-COV-2. Micocci M, Gordon AL, Seo MK, et al.
• COVID-19 testing in English care homes and implications for staff and residents. Micocci M, Gordon AL, Allen AJ, et al.
• COVID-19 point-of-care testing in care homes: what are the lessons for policy and practice? Buckle P, Micocci M, Tulloch J, et al.
• Mass testing after a single suspected or confirmed case of COVID-19 in London care homes, April–May 2020: implications for policy and practice. Tang S, Sanchez Perez M, Saavedra-Campos M, et al.
• Care homes and COVID-19 in Hong Kong: how the lessons from SARS were used to good effect. Chow L.
• Enhanced lateral flow testing strategies in care homes are associated with poor adherence and were insufficient to prevent COVID-19 outbreaks: results from a mixed methods implementation study. Tulloch JSP, Micocci M, Buckle P, et al.

Developing care home and resident centred research

• Establishing a set of research priorities in care homes for older people in the UK: a modified Delphi consensus study with care home staff Shepherd V, Wood F, Hood K.
• Fixing the broken image of care homes, could a ‘care home innovation centre’ be the answer? Hockley J, Harrison JK, Watson J, et al.
• Older care-home residents as collaborators or advisors in research: a systematic review. Backhouse T, Kenkmann A, Lane K, et al.
• Seeking Answers for Care Homes during the COVID-19 pandemic (COVID SEARCH). Spilsbury K, Devi R, Griffiths A, et al.