A new report from the NIHR (National Institute for Health Research) shows how clinical research is working to address the challenges faced by people working and living in care homes.
Advancing Care – Research with Care Homes, a themed review of NIHR-funded studies, looks at an area of research that has historically received less attention than hospital treatment, but which affects some of the most vulnerable people in our society.
Over 400,000 older people live in 19,000 independently owned care homes in the UK. In recent years, the number of residents living with severe frailty and multiple conditions has risen.
The themed review includes studies that test ways of improving nutrition and the quality of life of residents, as well as evidence on efforts to reduce depression and pain and manage incontinence. It also features research identifying the needs of residents with multiple serious conditions, as well as studies looking for better ways of managing the distress of people living with dementia.
Research in care homes is a relatively new and emerging field, where the evidence base isn’t as strong as it is in other areas of health research. But the NIHR is looking to bolster this, by funding new high quality research proposals. Homes are also calling for more studies, as they want a better understanding of how best to provide good-quality services.
The report features published findings from 23 studies and details of 21 projects that are taking place now. New studies are addressing the important question of what kind of workforce is required to deliver the best quality care and research has started to explore the pivotal role of the care home manager in creating a culture that enables change. The research aims to inform policy and care home level decision makers and to find the best ways of developing, supporting and organising staff and services.
Published by the NIHR Dissemination Centre, Advancing Care – Research with Care Homes also looks at best practice for future research.
Research featured in the themed review includes:
• a study finding that care homes accessed between 14 and 15 different professionals or services, such as district nurses, opticians, chiropodists and community psychiatric nurses, in a six-month period. However, the arrangements seemed to be on an ad hoc basis, and largely dependent on individual relationships between care home staff and NHS professionals.
• a multi-faceted trial of different approaches, including medicines review, exercise and social activity, which significantly reduced prescribing of anti-psychotic medicine for residents with dementia;
• a review on improving nutrition among care home residents with dementia. Helpful changes included playing music at meal time and replacing pre-plated meals with family-style meals.
• a study looking at producing a life story book to improve the wellbeing of care home residents;
• a study asking whether people with dementia in care homes are receiving regular sight tests to ensure prescriptions are up-to-date and identify who might benefit from cataract surgery.
NIHR researcher Claire Goodman, professor of health care research at the University of Hertfordshire, whose work features in the review, says: “This themed review demonstrates how research into the health care of older people living and dying in care homes can establish what needs to be in place to achieve good outcomes for this population.
“The NIHR is to be congratulated for funding research that cuts across the entrenched divides of health and social care to inform how commissioners and practitioners can address the priorities and needs of residents, families and staff.”
