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Missed meals, walks and toileting: U of A study reveals essential tasks missed in nursing home care

As dementia cases rise, a new study at the University of Alberta shows just how common it is for residents in Canadian nursing homes to go without being fed, bathed or taken for a walk.

57 per cent of care aides reported missing at least one essential task during their last shift.

Researchers say more complex dementia cases have put extra pressure on frontline staff. (BlurryMe/Shutterstock)

With the number of dementia cases on the rise, a new study at the University of Alberta suggests just how common it is for residents in Canadian nursing homes to go without being fed, bathed or taken for a walk.

The study found that 57 per cent of care aides reported missing at least one essential task during their last shift. Sixty-five per cent of workers reported rushing at least one of those tasks.

Essential care tasks include taking residents to the toilet, helping them dress, or simply talking to them.

"This is such a vulnerable population, and the care tasks we are talking about here are the essential care for them, like talking and walking, assisting them with eating," said co-author Dr. Yuting Song, a postdoctoral fellow at the University of Alberta and lead author of the study.

"Those are really the central ones to maintain their quality of life and to make sure we provide good quality of care for them." 
Lead researcher Yuting Song says the study provides potential direction to reduce missed care. (Yuting Song)

The study was conducted between May and December 2017 by Translating Research in Elder Care (TREC), a research partnership that specializes in improving elder care.

Researchers interviewed more than 4,000 care aides from 93 urban nursing homes in Alberta, British Columbia and Manitoba. TREC is based at the U of A's Faculty of Nursing.

Care aides were asked questions such as: "On your last shift, did you leave mouth care for residents undone because you did not have enough time?"

The findings were published in a recent article in JAMA Network Open, a monthly open access medical journal.

Higher needs

Unlike a decade ago, 80 percent of residents in nursing homes now have dementia, and the illness is more advanced, said Carole Estabrooks, principal investigator at TREC.

"So their medical needs and their social needs are much higher when they come to the home," Estabrooks said.

"Overall resources have stayed relatively flat compared to the increase in the complexity of the older adults they're taking care of. So that puts a lot of pressure on the frontline workforce."

But the study also found that care aides in better work environments were less likely to miss or rush those tasks.

"The good news is that this means the work environment could be modified to improve nursing home care," Song said. "This provides potential directions for future interventions to reduce missed care and rushed care."

Researchers said better teamwork and engagement in decision-making were among the factors that contribute to better work environments. 

The study found that at 37 percent, the most common missed task was taking residents for a walk. Workers most frequently rushed the task of talking with residents nearly 50 per cent of the time.

According to the Alzheimer's Society of Canada, there are about 25,000 newly diagnosed cases every year.