M = 81 years (SD = 11)
Note: all values have been rounded to the nearest whole number for consistency; M stands for mean; SD stands for standard deviation.
As a first step, we present the results of 41 studies on wishes and needs of NH residents, excluding those that used the CANE questionnaire. Subsequently, we present the results of the remaining ten studies that collected data on wishes and needs with the CANE instrument. This separation seemed reasonable, as the CANE questionnaire is the only instrument that explicitly distinguishes between met and unmet needs. Therefore, the separate presentation and summary of the CANE studies provide a comprehensive overview of the results collected with this questionnaire. The wishes and needs found in the 41 studies presented first could be mapped to 12 themes. These are shown in detail in Table 3 .
Explicit description of the themes.
Themes | Outcomes |
---|---|
(1) Activities, leisure, and daily routine | |
(2) Autonomy, independence, choice, and control | |
(3) Death, dying, and end-of-life | |
(4) Economics | |
(5) Environment, structural conditions, meals, and food | |
(6) Health condition | |
(7) Medication, care, treatment, and hygiene | |
(8) Peer relationship, company, and social contact | |
(9) Privacy | |
(10) Psychological and emotional aspects, security, and safety | |
(11) Religion and spirituality | |
(12) Sexuality |
The need to make the day active and momentous has been addressed in several studies [ 27 , 28 , 38 , 46 , 49 , 58 , 60 ]. Accordingly, wishes for meaningful, person-specific, enjoyable, social, and recreational activities were mentioned [ 27 , 28 , 38 , 46 , 60 ]. Residents like to practice their hobbies and consider activities on special occasions and events as important [ 27 , 38 ]. Various pursuits and leisure activities that residents like to do could be classified under this theme: Reading, listening to music, having contact with animals, keeping up with the news, spending time outside, doing activities outside the NH, playing games, partying, tea-time, gardening, helping others, doing crafts, and spending time with others [ 27 , 38 , 46 , 49 , 58 ]. In addition to the need for specific activities, a general wish for a varied life with diverse offerings and activities was also mentioned [ 60 , 62 ], in which residents can experience self-sufficiency [ 49 ].
Moving into an NH can result in a loss of autonomy and independence. Over half of the 41 studies [ 20 , 22 , 25 , 26 , 28 , 30 , 31 , 32 , 33 , 35 , 36 , 38 , 39 , 49 , 50 , 52 , 57 , 58 , 60 , 62 , 63 ] demonstrate that it is essential for residents to do things for themselves, to have a say in decisions, and to maintain their autonomy to the greatest extent possible. In various studies, NH residents described an experienced dependence and a wish to gain more autonomy and independence: “The stroke nurse who was to do the swallowing test never came. She was to sign me off for swallowing so that I could eat bread… You see I am very determined to be as independent as I can be? I would love to be able to walk to the toilet on my own” [ 52 ]. Residents reported a wish to make decisions for themselves or to be involved in the decision-making process and that this is central to their well-being and quality of life [ 60 , 62 ]. The need to have a say relates to both day-to-day issues and far-reaching decisions. For example, residents wish to have control over daily concerns such as deciding when to get up and go to bed [ 28 , 38 , 39 ], what clothes to wear [ 38 , 58 ], what and when they eat [ 28 , 39 , 49 , 63 ], how they spend their day [ 49 ], who they share a room with [ 39 ], and whether they participate in social activities [ 49 ]. Residents also want to make their own decisions on issues related to hygiene and care routines, including bathing and showering type, how often to bathe or shower, and oral hygiene [ 35 , 36 , 38 , 39 , 63 ]. Control over medical matters is highly important to many residents. For instance, residents would like to have a choice regarding how often and which physician they consult [ 35 , 39 ]. Residents are concerned about their future and would like to make advance directives and living wills. According to one study [ 67 ], over one-third of residents have a written advance directive, i.e., either an advance directive, or a living will, or a combination of different documents. Residents who already have an advance directive most often want their son or daughter, or a close relative, to act as surrogate decision makers should their own decision-making capacity cease [ 26 , 50 ]. In decisions concerning care, residents wish to determine who has a say for themselves. Some residents wish to make all decisions on their own, but many would also like family members and relatives to have a say, while still others would like staff or the attending physician to make final decisions and hand over responsibility to them [ 22 , 25 , 31 , 32 , 35 , 62 ].
To maintain a sense of freedom and independence, residents feel the need to regularly leave the NH on their own and independently [ 39 , 57 , 63 ]: “I tell a member of staff when I leave the NH. This is not a problem. Sometimes I am not back before midnight. I have a key. So, I can come and go whenever I want. That’s great. Because the staff do not have to give a key to the residents” [ 57 ]. Some residents want to move out of the NH or want to have control over their own discharge. This is partly based on the need to live in familiar surroundings again, but also on the wish for more self-determination and freedom [ 33 , 39 , 62 ].
People often move into a NH at a late stage in life, when the issues of dying and death become increasingly important. Residents have different ideas about the end of their lives and dying in the home. NH residents wish not to become bedridden and in need of care in the last phase of life. Furthermore, they wish that their health condition does not deteriorate further allowing for a degree of mobility and activity. Despite impending death, residents want to continue to make plans and be content [ 40 , 41 ]. Contact with family members, friends, relatives, and other confidants, such as nursing staff, or the attending physician, plays an essential role in this phase of life [ 40 , 66 ]. The results show that residents are concerned about discussing the topics of dying and death with familiar people. Residents want to prepare for death and plan for the process of dying and the time after [ 57 ]. In addition to a general need to talk about the approaching death, residents are particularly concerned about symptom management, emotional, psychological, and spiritual support, possible counseling services, and funeral issues [ 27 ]. One study [ 32 ] found that there is often a lack of opportunities to discuss one’s values and needs regarding end-of-life treatment and care with the nursing staff. Resident reactions to such staff discussions vary greatly from unnecessary to a very strong need. Wishes for pain management and more personal and time-intensive care include maintaining personal hygiene and the requirement of additional medical care in the last phase of life [ 40 , 56 ]. There are also clear wishes and needs on the part of NH residents regarding the dying process. In this context, several studies shed light on the context in which people want to die, such as the place of dying, the condition in which they want to die, and the people they would like to have by their side when dying [ 26 , 41 , 50 , 66 , 67 ]. In most cases, residents would like to die in the NH and not be transferred to another facility, such as a hospital. [ 26 , 41 , 50 , 66 , 67 ]. However, needs for passing away at home, in hospice, or in a hospital are also cited [ 66 , 67 ]. Most residents in one study [ 66 ] reported wanting to pass away in their sleep (31%). Fewer residents would like to be unconscious or comatose during dying (7%) and a small percentage would like to experience the dying process while conscious (3%). The other residents were not clear at the time of the survey about the condition in which they would like to die or did not make any statement for other reasons.
The question of end-of-life care also seems to be essential for residents. For example, most residents wish to die in the presence of familiar people, such as relatives, friends, nursing staff, or hospice companions. “That I can cling somewhere,… to any hands…” [ 41 ]. Others would rather be alone when the time comes [ 22 , 41 ]. When dealing with dying people, physical closeness, human warmth, support, and respectful, open, and honest communication are of great importance [ 41 , 66 ]. Medical and nursing factors are also central. Residents do not want to suffer pain and thirst during the dying process and want to be able to breathe comfortably [ 22 , 40 , 41 , 56 , 66 ]. Many residents do not want to receive life-sustaining measures, including artificial nutrition, resuscitation, surgery, heart–lung machine, ventilator, or dialysis, during the dying phase [ 22 , 40 , 41 , 56 , 66 ]. However, others want to receive life-sustaining treatment in the event of a life-threatening condition [ 50 ]. Residents consider a natural and quick death, which they see as a release, important [ 22 , 49 ].
Spiritual factors also play an essential role when residents face death in a NH. Residents want to die quietly and peacefully, which means that they do not want to be a burden on anyone and want to die without much fuss. They wish for forgiveness and reconciliation, for their mistakes not to be of great relevance in retrospect, and for their loved ones to think back on them positively after their passing [ 41 ]. During the dying process, residents feel the need to maintain their dignity and self-respect and to leave the world laughing [ 66 ].
The wish to die or to actively end life has also been cited in studies [ 33 , 57 , 66 ]. Three of 18 residents interviewed in the Goodman et al. study [ 33 ] want their life to end. Van der Steen et al. [ 66 ] found that residents wish to have ways to end life if they feel it is necessary.
Four of the 41 studies [ 24 , 27 , 60 , 62 ] captured residents’ financial wishes and needs. All four studies found a desire for more money or financial support and financial security. Chuang et al. [ 27 ] also found that residents feel a need to be able to pay the monthly NH fee. If this cannot be accomplished, residents would be discharged or transferred to another NH with lower standards, which they try to avoid.
Studies reported facility-related needs and needs at the structural level, for example, concerning the room occupied [ 19 , 20 , 36 , 38 , 46 , 47 , 60 , 62 ]. Residents wish for a comfortable bed [ 19 ], larger [ 62 ] and temperature-controlled rooms [ 36 ], and the ability to personally furnish the rooms with their own furniture, objects, photos, a television, and a radio [ 46 , 60 ]. Further, needs were expressed for housing facilities that are designed for the elderly and disabled such as the presence of elevators [ 62 ]. Clean housing and sanitary facilities are also important to residents. Regarding these, the wish for improvement was mentioned [ 20 , 62 ]. It is also essential that residents can take care of their own belongings and have a way to lock and store smaller items safely [ 19 , 36 , 38 ]. Other needs related to facility structure include a wish to separate residents with dementia from those without dementia and a wish for more flexible routines. For example, residents would like more flexibility in the timing of taking pills [ 62 ]. Culinary care in the NH also plays an essential role for residents. According to Sonntag et al. [ 62 ], residents feel the need for better food that is age-appropriate and not so monotonous. In addition, residents want to decide what food they get, how much of it, and whether they eat according to a recommended diet. Some wish for more traditional food to be offered and to take meals at their leisure, without time stress, at set times of the day, and with patient and respectful assistance if necessary [ 47 ]. Housen et al. [ 38 ] reported that it is important for residents to have snacks available at their convenience in the NH.
An inability of older people living alone with deteriorating health and physical condition often requires a transition to NH. Thus, the issue of health is of high importance for these NH residents. Most common among this theme was the need to maintain and improve health or to prevent a decline in health [ 33 , 49 , 57 , 60 , 61 , 62 ]. In this context, maintaining both cognitive and physical health status is of high importance. The abilities are seen as a prerequisite for enjoying the last years in the NH: “The few years I have left to live, I want to enjoy them. I can still walk, more or less, well around what you can call walking. You don’t need to put me in a chair yet, a wheelchair or one of them frames. Yeah, I do and wash myself and everything” [ 60 ]. As the worst imaginable scenario, residents describe their condition as a nursing case: “I have no expectations anymore. The principal thing is not to become a nursing case. I do not want to become an invalid like some of the other residents. I do not want to lose my mind. In this case, I would rather die” [ 57 ]. According to Schmidt et al. [ 61 ], residents wish to maintain their physical and sensory awareness.
Additionally, full and honest information about one’s health status is also noted to be essential. While three studies [ 20 , 26 , 60 ] reported that residents want to be fully informed about health status and, if applicable, fatal diagnoses, Gjerberg et al. [ 32 ] found that a small number of residents were unsure whether they might want to receive information of a severe nature or indicated that they did not want to receive information. This is due to fear of harmful consequences, “…that will just leave me thinking. And I would rather not”.
Wishes for mobility or physical activity [ 57 , 60 , 61 ], for physical comfort [ 63 ], and for restful sleep and sleep comfort [ 58 , 60 , 61 ] were also mentioned under the topic of health condition.
Thirteen of the 41 studies [ 18 , 19 , 20 , 27 , 30 , 33 , 35 , 37 , 42 , 46 , 49 , 58 , 62 ] addressed needs related to the behaviors or characteristics of nursing staff or care received. For example, residents want to receive care that is good [ 37 , 58 ], humane [ 62 ], continuous [ 37 , 42 ], competent, skilled [ 27 , 62 ], affectionate [ 62 ], encouraging [ 42 ], and professional [ 19 ]. According to Bangerter et al. [ 19 ], professional care in this regard can be defined as friendly, kind, courteous, emphatic, respectful, and characterized by symmetrical communication. Further, residents want to be perceived as individuals, treated personally and with dignity, and taken seriously [ 30 , 37 , 62 ]. This includes addressing residents personally by name [ 19 ]. They wish staff would reliably take care of them and be concerned about them [ 18 , 27 , 33 , 35 ]. Residents feel the need to trust the nursing staff [ 20 ] and have a good relationship with them [ 33 ]. Sensitivity and motivation on the part of caregivers are necessary to form a trusting relationship possible according to residents [ 42 ]. This does not always seem to be guaranteed: “Not too many of them help too much when we’re not well-they don’t have feelings… They are tired-they have to lift me and I’m heavy. If they have a bad day or bad night, they lose the ability to be sensitive to our condition. Sometimes I feel that they take their frustrations out on us. They lack a little sensitivity” [ 42 ]. Residents wish they were not treated as if they were a nuisance, a problem case, or a child [ 46 , 49 ].
In addition to needs primarily related to nursing staff, residents also reported wishes and needs related to medical care and hygiene. According to different studies [ 42 , 58 , 61 ] personal hygiene is important to residents. This includes bathing and washing facilities [ 58 ], oral hygiene, and regular changing of linens [ 42 ]. In one qualitative study with 10 women and 10 men, some women reported a gender-specific need for personal care to be performed by a caregiver who is a woman herself [ 37 ]. High-quality medical care includes the use of proper equipment during treatments [ 20 ], good skin and wound treatment, expert pain management to prevent discomfort due to physical illness [ 61 ], and monitoring for adverse drug reactions [ 46 ]. Referring to the study by Michelson et al. [ 45 ], residents refuse aggressive medical treatment unless the intervention alleviates pain or results in greater patient comfort or safety. Nakrem et al. [ 49 ] and Sonntag et al. [ 62 ] found that residents hope to receive more active care in the NH, more therapeutic interventions, more physical therapy, and regular fall prevention by NH staff. To provide more quality of life in the NH, residents wish for more help and support with daily living activities [ 27 , 62 ]. Frustration is reported because this support is not provided by staff without being asked [ 42 ]. Residents reported care needs for eating and drinking, excreting, constipation, sleep disturbances, loss of appetite, chronic illnesses (including asthma, arthritis, hypertension), and visual impairment [ 23 , 61 ]: “The constipation has given me piles in that my whole body is affected” [ 23 ].
In the study by Levy-Storms et al. [ 42 ], excessive cross-boundary support from nursing staff is sometimes reported: “Let me eat (feed myself) with a spoon, like normal people”. This is countered by the reports of residents who experience a lack of individualized and skilled care and attention from NH staff. This is seen as a problem of limited staff capacity, which is why the wish for more staff was mentioned to make the above-mentioned needs and wishes feasible [ 62 ].
Contact with other people is a central need for many NH residents. While a good and trusting relationship with the nursing staff has already been presented as the basis for humane and personal care, residents name social contacts and friendships as significant for a satisfying life in the NH. Residents described needs for sociability and conversation in their lives [ 30 , 62 ], for human connection [ 52 ], for belonging [ 30 ], for a good and personal atmosphere in the home [ 60 ], for harmony [ 23 ], and for meaningful relationships [ 55 ].
Relationships with other NH residents are highly relevant, as these play a significant role in determining the daily environment. Residents actively choose their contacts in the NH, talking about their experiences in the home, their past lives, and their families. They spend time together and do things together: “I am in touch with Anna. She lives down the corridor. She is lucid, and we can talk. She comes to visit me, and then we talk… and if she gets some sweets, she comes to me [to share] and if I get something she appreciates from my family, then I share it with her” [ 21 ]. Residents reported a wish for all residents to live better together [ 62 ] and a desire for personal and social relationships with other residents [ 21 , 27 , 28 , 49 , 60 ].
In addition to the need for in-home relationships with peer residents, the wish for good relationships with family members, relatives, and friends outside the home was also frequently mentioned. For example, residents would like to maintain family and friendship ties [ 21 , 27 , 28 , 52 , 60 , 63 ] and spend more time with and are regularly visited by their loved ones [ 18 , 20 , 21 , 30 , 35 , 62 ].
Residents also wish to maintain contact with their former social environment and the community they lived in before moving. Residents do not want to lose connection to their former lives and the world outside the NH [ 28 , 49 , 52 , 63 ]: “I like getting out to the town, you know. I just like to see if there is any building going on or what’s happening in the town” [ 52 ]. Residents indicate they want to maintain their past relationships and ties because they are identity-building [ 52 ]. Ways to maintain a connection to the outside world include: watching television, listening to the radio, reading the newspaper, or sitting at the front door to watch people come and go [ 63 ].
As important as human contact is, a certain degree of privacy is likewise important. This was shown by seven studies [ 19 , 20 , 27 , 28 , 33 , 38 , 60 ]. Residents desire privacy when using the restroom and performing personal hygiene [ 19 , 60 ]. The wish for privacy further includes the need for a private space [ 60 ], which residents understand to mean, for example, occupying a single room [ 28 ], but also being able to receive visits or make telephone calls in a private setting [ 38 ].
Quietness in the NH is also crucial to residents’ privacy. They wish to rest undisturbed [ 33 ] and that they are not disturbed by loud noises [ 60 ].
Residents who inevitably interact with others due to the institutional setting want to spend time alone [ 60 ] and consider it important for social and psychological privacy that nursing staff knocks upon entering the room [ 28 ]. Cooney et al. [ 28 ] found that residents of large facilities particularly complained about a lack of privacy. In some cases, beds are separated only by curtains, which ensures a very low level of quiet and privacy: “You only have a curtain separating you” [ 28 ].
Many of the wishes and needs of residents are also in the psychological, emotional, and safety domains. Inner-personal and psycho-emotional needs, for example, were named in the study by O’Neill et al. [ 52 ]. Residents wish to have a positive attitude and maintain their own identity, self-efficacy, resilience, and coping strategies. They would like to take each day as it comes and not worry too much about tomorrow. According to Franklin et al. [ 30 ] and Schmidt et al. [ 61 ], residents want to experience a daily routine, to be able to enjoy the little things in everyday life, and to find a sense of meaning in the NH’s daily routine to experience themselves as part of the environment. It seems essential for residents to have a sense of belonging, to feel understood, and to have a sense of community [ 60 ]. Other studies report similar findings [ 28 , 61 , 63 ]: residents want to be themselves, not lose a sense of self, and be recognized as independent individuals. To ensure this, residents are concerned about their appearance among others. One qualitative study showed that some women want to take care of their appearance. They state that this has a positive effect on their self-expression and self-esteem [ 28 ].
Further, having options to do what they want when they are miserable is essential [ 18 , 36 ]. Fundamental to residents is that they feel needed, valued, and welcomed [ 27 ]. Schmidt et al. [ 61 ] also found that expressing emotions, expressing one’s will, being talked to and touched, as well as touching others are important for residents’ emotional and psychological well-being. NH residents wish for social and emotional support in the home [ 46 ] and psychological support for depression, confidence loss, memory loss, anxiety, anger, and irritability [ 23 ].
A sense of security is also important to residents. They wish to be safe and secure in the NH [ 49 , 60 , 61 ]. This includes knowing that the home has safety and security measures installed and that residents always have quick access to emergency services [ 20 , 49 ]. Being protected from self-harm and from disturbance by other residents is also part of living safely in an NH [ 46 ].
Religiosity and spirituality play an important role for many residents. For example, they wish to participate in religious ceremonies [ 27 , 38 , 43 , 58 , 61 ]. They want to express themselves religiously in their lives, follow cultural customs, and feel spiritually connected to others [ 27 , 38 , 61 , 63 ]: “I can’t go to the Sunday ceremony, but I read the Bible by myself… You will feel consoled after you read it” [ 27 ]. Specific activities that residents undertake to meet their religious and spiritual needs are cited by Man-Ging et al. [ 43 ]: praying for themselves, reflecting on past lives, turning to a higher presence, and plunging into the beauty of nature.
One study [ 48 ] addressed the sexual needs of NH residents. More than half (51%) of the residents surveyed reported a sexual tension, including more men (65%) than women (41%). In addition, residents reported the following as their most important sexual needs: need for conversation, need for respect, need for tenderness, need for support in any situation, and need for giving and receiving emotional support, by which residents primarily mean empathy and understanding.
The ten studies that used the CANE questionnaire for data collection are presented separately. The CANE questionnaire covers 25 areas of daily life in the NH to assess older people’s physical, psychological, social, and environmental needs. A distinction is made between met and unmet needs. Table 4 shows the outcomes of CANE studies and gives an overview of the five most frequently mentioned needs in each of these ten studies. Eight studies reported both unmet and met needs [ 29 , 34 , 44 , 51 , 54 , 59 , 64 , 68 ]. One study reported only unmet needs [ 53 ], and the study by van der Ploeg et al. [ 65 ] reported the sum of met and unmet needs differentiated between residents with dementia, residents without dementia, and relatives. Looking at the results without including the study by van der Ploeg et al. [ 65 ], the five most frequently mentioned met needs are in the areas of food, household skills, physical health, accommodation, and self-care. In comparison, the five most frequently unmet needs are in the areas of daytime activities, psychological distress, company, eyesight/hearing, and memory. Some of the five most frequently identified needs that residents have according to CANE studies were also highlighted by the analysis of the 41 other studies. These include the following needs in the area of unmet needs: daytime activities, psychological distress, and company. The met needs, which have also been addressed by the other studies, are as follows: food, physical health, and accommodation. Additional needs identified through the CANE studies that have not been mentioned in the previous analysis are household skills and self-care in the area of met needs and memory and eyesight/hearing related to unmet needs.
Outcomes CANE studies.
Study | Met Needs Top 5 | Unmet Needs Top 5 | |
---|---|---|---|
Ferreira et al. (2016) Portugal [ ] | 1. Household Skills 2. Food 3. Physical health 4. Drugs 5. Money | 1. Daytime activities 2. Eyesight/hearing 3. Psychological distress 4. Company 5. Memory | |
Hancock et al. (2006) UK [ ] | 1. Household skills 2. Accommodation 3. Self-care 4. Money 5. Food | 1. Daytime activities 2. Psychological distress 3. Memory 4. Eyesight/hearing 5. Behavior | |
Mazurek et al. (2015) Poland [ ] | 1. Food 2. Physical health 3. Household skills 4. Accommodation 5. Mobility/falls | 1. Company 2. Psychological distress 3. Eyesight/hearing 4. Intimate relationships 5. Daytime activities | |
Nikmat and Almashoor (2015) Malaysia [ ] | 1. Accommodation 2. Looking after home 3. Food 4. Money 5. Self-care | 1. Intimate relationships 2. Company 3. Daytime activities 4. Caring for another 5. Memory | |
Orrell et al. (2007) UK [ ] | n.a. | 1. Daytime activities 2. Memory 3. Eyesight/hearing 4. Company 5. Psychological distress | |
Orrell et al. (2008) UK [ ] | 1. Food 2. Accommodation 3. Household skills 4. Mobility/falls 5. Self-care | 1. Daytime activities 2. Company 3. Psychological distress 4. Eyesight/hearing 5. Information | |
Roszmann et al. (2014) Poland [ ] | 1. Drugs 2. Physical health 3. Self-care 4. Household skills 5. Continence | 1. Accommodation 2. Memory 3. Food 4. Psychological distress 5. Company | |
Tobis et al. (2018) Poland [ ] | 1. Looking after home 2. Food 3. Physical health 4. Accommodation 5. Self-care | 1. Company 2. Psychological distress 3. Eyesight/hearing 4. Intimate relationships 5. Daytime activities | |
van der Ploeg et al. (2013) Netherlands [ ] (Here presented the sum of met and unmet needs distinguished between residents with and without dementia and relatives as proxies) | Residents with dementia 1. Household skills 2. Food 3. Mobility/falls 4. Self-care 5. Physical health | Residents without dementia 1. Household skills 2. Mobility/falls 3. Food 4. Accommodation 5. Physical health | Relatives 1. Food 2. Household skills 3. Accommodation 4. Mobility/falls 5. Self-care |
Wieczorowska-Tobis et al. (2016) Poland [ ] | 1. Physical health 2. Caring for another 3. Mobility/falls 4. Food 5. Continence | 1. Daytime activities 2. Company 3. Psychological distress 4. Eyesight/hearing 5. Intimate relationships |
The objective of this scoping review was to identify the wishes and needs of NH residents. The results show numerous needs that were mapped to 12 themes. In 35 studies, residents were interviewed; in 12 studies, residents and proxies were interviewed; and only proxies were interviewed in four studies. This shows that residents can be aware of perceived needs and wishes and can communicate them. This is valid not only for residents without cognitive impairment [ 69 ], but also for residents with dementia [ 11 ]. Studies show that third-party assessments of needs sometimes differ from what NH residents report [ 20 , 35 , 44 , 46 , 54 , 65 ]. This finding is especially important for residents with dementia, as needs elicitation for these individuals is often only collected through a proxy survey [ 11 ]. It is essential to directly survey NH residents, including residents with dementia, about their wishes and needs. Interviewing proxies can provide additional and helpful information, but is not a substitute for speaking directly with the affected resident.
The scoping review results further indicate that wishes and needs on specific topics differ between individual residents. For example, some would like to receive life-sustaining measures, while others reject them. This high degree of individuality and complexity must be considered in assessing needs. The wishes and needs should be recorded with the individual residents in private conversations, reflected on repeatedly, and the way they are dealt with should be adjusted if necessary. This requires time, expertise, and willingness. Often, there is a lack of human resources to ensure this task is completed. Complaints about a shortage of skilled workers and high workloads in NHs are frequent. [ 70 , 71 ]. These circumstances can lead to less quality in care and can make it difficult to have an individualized approach to residents [ 72 ]. Assessment tools, such as the PELI-NH or CANE questionnaire, can be helpful in conducting a comprehensive needs assessment. Such tools can provide clues to existing needs and wishes and present an overview. The CANE questionnaire, for example, does not address all the areas in which NH residents experience needs. Topics that are relevant for residents according to the present study, such as death/dying, autonomy, interaction of nursing staff with residents, and religion/spirituality, are not surveyed by this instrument. When caregivers or other persons refer to the CANE questionnaire in order to assess needs, they should be aware of this. Accordingly, in-depth and recurring interviews with residents are indispensable to consider the high complexity and individuality of wishes and needs. Only in this way can the results be validated and unmet needs can be discovered.
Themes of high relevance seem to be the following, as they were mentioned frequently and in multiple studies: “autonomy, independence, choice, and control”, “death, dying, and end-of-life”, and “medication, care, treatment, and hygiene”. Notably, needs cannot be categorized in a blanket way in which some needs are of higher importance than others. For example, needs in the nursing area may weigh the heaviest for some residents, while others consider the needs for autonomy and self-determination to be most important.
Older adults are aware of their wishes and needs, but in many cases they do not communicate them [ 73 ]. Sometimes, when asked about their wishes and needs, residents report that they do not wish for anything because nothing would change anyway. The reason for this seems to be an experienced lack of respect for their wishes. For residents who have the feeling that their personal and subjective wishes and needs are not heard and that addressing them does not lead to any change, communicating their needs does not make sense [ 62 , 69 ]. As another reason for non-communication, older adults in home care state that they do not want to be a burden to anyone, and they do not want to complain about the age-related ailments that are common for them [ 73 ]. In these situations, caregivers should treat residents with appreciation and respect. It is important to schedule sufficient time to talk about wishes and needs. It is also important to take residents seriously and show them that expressing their wishes and needs will lead to positive changes in their lives by addressing them. The patronizing communication that often occurs on the part of NH staff may also contribute to NH residents not always openly communicating their wishes and needs, as satisfaction with such interactions can be low [ 74 ]. Further, the use of elderspeak due to stereotypical expectations of NH residents’ communication skills can lead to residents not feeling understood or respected and, as a result, they tend to be quiet and accept things without argument [ 75 , 76 ]. As a result, non-communicated needs go unrecognized and, accordingly, unmet. Communication training or person-centered interventions for caregivers could contribute to improved caregiver–patient communication, which could lead to more openness on the part of the residents and, consequently, fewer unmet residents’ needs [ 77 , 78 ].
Shared decision making was a frequently mentioned need. However, sometimes less is more. The study by Reed et al. [ 79 ] shows that older people prefer to have fewer options from which to choose than younger people. This suggests that some NH residents may be overwhelmed by too many options. NH staff should individually ask residents whether they prefer to choose from reduced options in some areas of their lives.
The present study has some limitations. First, it must be said that the concepts of “wishes” and “needs” are very complex, and there is no common definition [ 80 ]. This can lead to the fact that all researchers involved understand something different by the concept under investigation. A definition was created and applied throughout to prevent this from happening and to ensure consistent study inclusion, data extraction, and analysis. Further, the 51 included studies are diverse in research design, study population, and objectives. For example, there are studies that surveyed residents as well as studies that surveyed proxies. Some studies focused on residents with dementia, while others focused on residents without cognitive impairment, or on unbefriended residents. The research focus was not primarily on wishes and needs in all studies. Constructs such as quality of life, dignity, or thriving were sometimes of substantial research interest. However, relevant wishes and needs were mentioned in the survey on these constructs, which were analyzed here. In the analysis of the quantitative studies, only the five most frequently mentioned wishes and needs were recorded in each case. The disadvantage here is that some wishes and needs were not recorded as a result. As qualitative studies do not include frequencies and therefore no ranking, all needs and wishes were extracted in these, which can lead to an overweighting of the qualitatively surveyed wishes and needs. Further, only studies in English and German were included. This can be explained by the language skills of the researchers but presents the possibility that relevant studies were not included. Consequently, the results only represent an overview of possible wishes and needs as stated by residents or their proxies. In no way do the results claim to be exhaustive of all wishes and needs of NH residents.
Among this study’s strengths is a very extensive literature search of 12 databases that was conducted. Additionally, the evidence examined is extensive, with 51 studies, as demonstrated by the high richness of results.
Twelve topics were identified to which the wishes and needs of NH residents can be assigned. This reflects the high complexity and diversity of the needs and wishes of the heterogeneous group of NH residents.
For many NH residents, the NH represents the last phase of life before death. Residents should live a contented and fulfilling life in the home. Essential to achieving satisfaction is the fulfillment of individual wishes and needs. A comprehensive needs assessment on resident wishes and needs should take place in NHs. Speaking directly with the residents is essential to success.
The results of this study provide an evidence-based framework that can serve as a basis for holistic and person-centered care in NHs.
This research received no external funding.
R.S. contributed to the design, evidence search, data extraction, data analysis, and drafted the manuscript. J.L.O. contributed to the design, evidence search, data extraction, data analysis, and revised the manuscript. M.K. contributed to the design, evidence search, data extraction, data analysis, and revised the manuscript. S.N. initiated the study, contributed to the design, and revised the manuscript. A.T. initiated the study, contributed to the design, and revised the manuscript. All authors have read and agreed to the published version of the manuscript.
The authors declare no conflict of interest.
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Working in a nursing home became the most dangerous job in America when the COVID-19 pandemic started, according to U.S. News and World Report .
The COVID-19 pandemic heightened the nursing shortage happening across healthcare. However, the shortage of nurses in nursing homes has been chronic for decades. Staff-to-patient ratios were already at a dangerous level.
The pandemic came and worsened the causes of the shortage. Now, in the face of imperfect solutions, nursing homes struggle to hire and retain quality staff and keep their doors open.
Nursing homes already struggled to hire and keep staff before COVID-19. Poor pay, lack of respect, unsafe conditions, and unreasonable workloads worsened when the pandemic hit.
Despite certified nursing assistants (CNAs) making up the majority of the nursing home workforce and providing most of the direct nursing care for residents, CNAs are paid the least and are the most at risk for work-related injuries, according to the American Association of Retired Persons (AARP).
What’s more, nursing home workers provided the same physically and emotionally demanding care, but in more hazardous conditions and with a smaller staff.
The COVID-19 pandemic added infection control issues to the staffing shortage. About 20% of nursing homes did not have enough personal protective equipment (PPE), according to Brian E. McGarry et al. in October 2020. Nursing home workers reused PPE or used inadequate quality PPE while providing care to patients with and without COVID-19.
The staff turnover rate before the pandemic was 94%, according to Health Affairs data from 2017 and 2018. During the pandemic, nursing home staff quit at higher rates than any other healthcare professional because they were unwilling or unable to work in unsafe conditions.
According to the American Health Care Association , as of June 2022, nursing homes still had dire understaffing levels on several fronts:
In 2001, Centers for Medicare and Medicaid Services published a study establishing the importance of minimum staff-to-patient ratios in nursing homes. The study suggests that nurses provide each nursing home resident with at least 4.1-4.85 hours of direct nursing care per day, depending on how long the resident stays in the nursing home.
These minimum hours should include a mix of care from registered nurses (RNs), licensed practical nurses (LPNs), and CNAs in varying amounts.
Because of poor funding, high staff turnover and burnout, and unsafe working conditions, many nursing homes do not meet these minimum standards. However, there are few consequences if nursing homes fall short of these safe-staffing standards. Nursing homes can remain open, and nursing home staff can keep their licenses.
Nursing homes and their staff will only face consequences if short staffing causes harmful outcomes for patients. Some of these harmful patient outcomes that can cause nursing staff to lose their licenses and become civilly and criminally liable include:
To complicate things further, 30 states established their own mandatory minimum number of hours of direct nursing care per resident per day. All 30 states mandate fewer hours of direct nursing care than the national recommendation.
These state requirements are well below the individual healthcare needs of each resident. Nursing homes can also apply for waivers, provided by Congress , rather than meet the requirements in some cases.
Congress does not lay out specific rules for how much staff a nursing home needs to hire. Congress currently only requires long-term care facilities to provide:
Because Congress has not set mandatory minimum staffing requirements yet, states have taken it upon themselves to dictate staffing requirements. New York, Rhode Island, and Massachusetts increased their mandatory minimum staffing requirements. Other states such as Georgia, Oregon, and South Carolina temporarily or permanently decreased their requirements.
Mandatory staffing minimums may help staff-to-patient ratios, but currently, Congress has not set one. And states cannot agree on how many staff members should be required.
Nursing homes have known about the dangers of short staffing since the 1980s. Yet, sometimes, they intentionally hire fewer people to cut labor costs.
According to Kaiser Health News, many nursing homes inaccurately represented how many people they had on the payroll and got away with it too. That is, until the Affordable Care Act in 2010 required nursing homes to turn in their daily payroll reports as a way to verify how many people were on staff.
About half of nursing homes failed to meet CMS recommendations for total staff 80% or more of the time between April 2017 and March 2018, according to Health Affairs data from July 2019.
Payroll data shows that all types of nursing homes did not meet CMS recommendations for the average hours spent with each resident. The average number of hours spent with each resident per day in for-profit nursing homes failed to meet even the lower requirements of the states, such as the 3.5 hours that California law requires.
LPNs do not face the challenges of poor pay, physically demanding work, and lack of advancement as much as RNs and CNAs do. In fact, nursing homes were mostly likely to staff the required number of LPNs.
Skilled nursing facilities pay LPNs the highest average annual salary, according to data from the U.S. Bureau of Labor Statistics (BLS), and they are not expected to do as much physical work as CNAs.
However, along with CNAs, nursing homes also offer poorer-than-average salaries for RNs , according to BLS data.
RNs may have more opportunities for advancement in other healthcare settings compared to CNAs. For CNAs, the physical demand of working in nursing homes is higher than if they choose to work in home health or assisted living.
Insufficient staff-to-patient ratios do not have an easy solution. Nursing homes get most of their funding from Medicare and Medicaid. CMS reimburses nursing homes with a bundled payment system, so nursing homes receive one lump sum per patient per day.
The nursing home decides, based on the patient’s needs, the most important care for the patient. Many specialties fighting for a single pot of money means smaller salaries for staff and limited funds to hire new staff. Patients may not get care from all the specialties they need or for as long as they need.
Nursing homes solutions are incomplete and imperfect. Government officials from both political parties have tried to improve the quality and cost of nursing homes for decades with little success.
The most successful and workable solution will likely involve a mix of solutions from staff and nursing home leadership.
Congress could make a law that requires nursing homes to give each resident 4.1-4.85 hours of direct care per day. However, the law would be difficult to enforce.
The minimum staff requirements that some states passed may help patients, but a flat number of staff may not help patients who need more attention or direct care than average. Nursing homes can and have worked around minimum staffing rules by hiring temporary staff right before inspection.
Nursing homes try many different solutions to get more staff. However, they face issues because of the poor reimbursement rates and the lack of qualified or interested candidates.
To try to cope with the staff shortage, nursing homes may:
High levels of turnover and burnout create an endless loop of staffing shortage in nursing homes. Nursing homes need good-quality CNAs, LPNs, and RNs to decrease the workload and make working conditions safer. Yet, good quality CNAs, LPNs, and RNs will find jobs elsewhere as long as nursing homes have such high workloads and unsafe conditions.
Nursing staff should help each other out when they can and make the most of the few resources they have. They should stick up for themselves, their coworkers, and their patients to minimize harm.
In an ever-evolving field, nurses face several key challenges moving into the new year. For nurses considering changing careers, experienced nurses offer advice.
The pandemic has highlighted many ongoing issues in the nursing profession, especially the shortage of nurses. Review what states are doing to manage the deficit and address the issue looking forward.
Check out these tips from nursing experts on how to prevent and recover from nurse burnout and compassion fatigue.
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By Patrick Skerrett July 20, 2024
F irst Opinion is STAT’s platform for interesting, illuminating, and maybe even provocative articles about the life sciences writ large, written by biotech insiders, health care workers, researchers, and others.
To encourage robust, good-faith discussion about issues raised in First Opinion essays, STAT publishes selected Letters to the Editor received in response to them. You can submit a Letter to the Editor here , or find the submission form at the end of any First Opinion essay.
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“Why aren’t philanthropists stepping up to make nursing education free?” by Tracy R. Vitale and Caroline Dorsen
The shortage of nursing faculty at both the associate degree in nursing and the bachelor of science in nursing levels, primarily due to salary structures, has been well documented for at least a couple decades within nursing and health care access advocate circles. Where it’s not known — at least not with a powerful and energized message — is within the circles of college and university development offices and community foundation fundraisers. People of wealth have both personal and professional connections to nursing, whether as practitioners, patients, family members, or community leaders. The full-bore messaging and cultivation of these donors and funders just isn’t out there. Without an active change in strategies, the current pleas aren’t going to get us where we need to go. Time to regroup!
— Allen Smart, PhilanthropywoRx
It’s a shame that more philanthropists don’t support nursing education. But nursing schools are also to blame due in part to the arrogance of the requirement that a prospective nurse repeat anatomy and physiology 1 and 2 and microbiology if it’s been more than 5 years since she or he has taken those courses. I have repeated those courses once and earned “A” grades in them. I was in my nursing clinicals when Covid-19 shut everything down. Now I can’t afford the tuition and I refuse to repeat those classes. There is no such requirement for medical school. It’s the nursing school and society’s loss: I would have been a great nurse!
— Thomas Martin
A major issue has to do with the lack of nurse educators. I obtained my MSN-Ed with the idea of becoming a nursing school educator, but was unable to financially make this transition. Nursing school educators make significantly less than patient care nurses. Lack of instructors is why many who are interested in becoming nurses are turned away.
— Kim Blanton, retired
“Functional neurological disorder is not an appropriate diagnosis for people with long Covid,” by David Tuller, Mady Hornig, and David Putrino
I have struggled with a neurological disability for 21 years. It came to a head following an adverse reaction to the Covid-19 vaccine and development of long Covid (though I am grateful that the vaccine protected me from earlier strains of the virus). Since that fateful day in February 2021, I have been rushed to an emergency department 29 times. And while I have been shown true humane and compassionate care by professionals working during the Covid pandemic, I was also repeatedly gaslit, mislabeled, and prevented from receiving the care I should have.
I’m not alone: An April 15, 2024, research letter in JAMA reported that nearly 1 in 4 patients in more than 29 hospitals had misdiagnoses or delays in diagnostic work-ups because of stigmatizing language in their medical records.
As a social worker who believes in social justice, I wonder how many people with long Covid symptoms — like those with chronic fatigue syndrome and Lyme disease and post-viral illness — have been dismissed, and their symptoms overlooked, and their care options missed. In hope for change, I rest my heart on the wisdom from a moving self-reflective medical narrative by Dr. Wes Ely in his book, “Every Deep Drawn Breath.” He wrote, “Many people believe medicine is grounded in benevolence , which is wishing good . It is more than that. The target principle of medicine must be a higher standard: beneficence . Doing good .” As he shares this, it is the covenant of all health care professionals to practice with self-reflection, humane connection, and compassion, make diagnostic queries with curiosity and care, and avoid labeling and words that harm, pathologize and damage.
— Kate Nicoll, LCSW
“Medicare drug pricing rules will delay access to promising therapies,” by Peter Rheinstein
Yes. We already have a problem with the lack of incentives to improve the use of drugs approved decades ago before we had the current tools of modern pharmacology. We fail at personalized medicine for such drugs which can improve both safety and efficacy. Research costs money and price controls will discourage more of the real-world evidence that requires better measurement for better dosing decisions in individuals.
— Peter T. Kissinger, Purdue University + Inotiv + Phlebotics
“Doctors ‘overprescribing’ opioids isn’t the cause of the overdose epidemic — and it never was,” by Richard A. “Red” Lawhern
Casey Heely of Brandeis University has protested what she believes is “over-simplification” on my part of the causes of the U.S. opioid crisis. In response to her concern, I would observe that major pharma companies clearly overpromoted the safety of prescription opioids. But data published by the U.S. Centers for Disease Control and Prevention establish beyond any rational contradiction that any contribution of prescriptions opioids was strictly at the margins of a much larger crisis driven by street drugs. Restrictions on the availability of prescription opioids have actually made the crisis worse, by driving desperate patients into street markets.
Over-prescribing was never the major factor in the rising rates of opioid overdose deaths. That distinction belongs to illegally manufactured fentanyl and heroin. Prescription opioids get lost in the noise.
— Richard A. Lawhern, Ph.D.
Patrick skerrett.
Acting First Opinion Editor
Patrick Skerrett is filling in as editor of First Opinion , STAT's platform for perspective and opinion on the life sciences writ large, and host of the First Opinion Podcast .
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By Maureen Dowd
Opinion Columnist, reporting from Washington
Suddenly, Donald Trump looks enlightened about women.
Sure, he’s in a 1959 time warp, like some spray-tanned, comb-over swinger in a Vegas lounge, talking about skirts and broads.
Sure, he filled the Supreme Court with religious zealots ending women’s rights.
Sure, he has been held liable for sexual abuse, accused of groping and caught talking about his right to grab women by their lady parts. He cheated on his first wife with the woman who became his second wife and then had flings when he was married to his third wife. He betrayed Melania with a porn star while she was home nursing their son and humiliated her again when the Stormy Daniels case went to trial. (See: Why Melania did not give a convention speech.)
Sure, his convention beatification was a dated homage to machismo, with Hulk Hogan tearing his shirt off and the U.F.C.’s Dana White introducing Trump as a fighter.
And yet, somehow, Trump managed to choose a vice-presidential pick whose views on women are even more draconian and meanspirited than his own.
JD Vance, he of many names , is off to a thudding start. He went on Megyn Kelly’s podcast Friday for cleanup on Aisle Feline. She sympathetically asked him about his 2021 rant to Tucker Carlson that top Democrats — Kamala Harris, Pete Buttigieg and A.O.C. — were “a bunch of childless cat ladies who are miserable at their own lives and the choices they’ve made, and so they want to make the rest of the country miserable, too.”
Vance explained to Kelly: “Obviously, it was a sarcastic comment. I’ve got nothing against cats.”
Ha. Ha. Ha. He’s the Republican Party’s biggest wit since that laugh riot Sarah Palin.
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| List of old age home in Elektrostal (Moscow Oblast, Russia) |
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Opponents cited three major arguments against nursing homes: cost and quality, reduction of self-reliance and independence and the trauma it entails to the loved ones. In terms of costs, it is reported by Ellis (2013) that nursing home services now costs up to $80,000 a year in comparison to its $67,527 five years ago.
Many individuals tend to see the many positive aspects of nursing homes. For example, the constant availability of care, when provided in a fair, caring manner, is very beneficial to some patients whose family simply cannot take care of them as much as they have to (Wood, par. 3). A large benefit to this constant care is a structured schedule ...
Nursing Argumentative Essay Topics for College. Nursing burnout: causes, effects, and solutions. Addressing the global shortage of nurses. The impact of healthcare policies on nursing practices. Ethical considerations in genetic testing: A nurse's perspective. The role of technology in enhancing nursing care.
Exploring Controversial Issues in Nursing: Key Topics and Examples. 7. Pediatric Nursing Research Topics for Students: A Comprehensive Guide. Explore various nursing argumentative essay topics to inspire thought-provoking discussions and help you develop strong critical thinking and writing skills.
Nursing Homes: Inadequate Staffing and Mandatory Overtime Argumentative Paper Taneshia Collins PHIL347N-Professor Metz October 22, 2023 The present debate about nursing homes centers on the fundamental issue of insufficient staffing and necessary overtime, stressing the delicate balance between delivering high-quality
The Eden Alternative is a nursing home model of care that places decision-making power into the hands of its clients and their families. Future Care Nursing Home in Baltimore City. In the United States, up to one-half of the citizens will spend at least a few years of their lives in a nursing home.
Argumentative Essay Nursing Homes. Just the mere mention of "nursing home" causes most people to shudder and think, "I would never put my relative in such a ghastly place.". There are a great deal of horror stories that stem from nursing homes, most along the lines of , " My mother was neglected after I put her in a nursing home.
Argumentative essays are a popular type of academic writing. They require students to develop and articulate a clear position on a given topic. The position taken in an argumentative essay should be backed up with evidence, reasoning, and examples. When it comes to choosing a topic for an argumentative essay, nursing students have a wealth of ...
Here are some tips to help you choose the perfect topic for your next nursing argumentative essay. 1. Pick a topic that you're passionate about. - If you're going to be writing about a topic, it's important to choose one that you care about. Otherwise, it'll be difficult to stay motivated throughout the writing process.
Revision- go through the content and look for grammatical or spelling errors, if any. Focus on the structure of the essay. 2. List tips on how to write a nursing school application essay. Focus on being informative- while framing the essay, be mindful of the information you include. Make sure it is backed by some evidence.
Shared Governance in Nursing Homes The concept of shared governance in nursing is not a new one, but rather has been recognized since the 1970s as a key indicator of excellence in the nursing practice and specific departments and institutions (Cherry & Jacob 2005, pp. 276-8). In a study of nursing home facilities in particular, it was determined that nursing leadership style had a great deal ...
At least 65% of the people that live in retirement homes have something to do with mental health such as (what we mostly hear about) Alzheimer's, dementia, Parkinson and many more. These patients require very special and strict care, and sadly but true; many family members cannot provide them with what they need.
In this blog, we've compiled a range of nursing paper topics that cover various aspects of nursing practice and theory. By exploring these prompts you'll be able to craft a compelling essay that showcases your potential as a future healthcare professional. So, let's begin with the first list of topics! On This Page. 1.
Here are some of the most Strong Persuasive Nursing Essay Topics ones: How effective nursing care can prevent chronic illness. The importance of teamwork in nursing care. How nurses can provide emotional support to their patients. The benefits of breastfeeding for infants and mothers. The importance of sleep for both infants and adults.
assignment paper nursing homes inadequate staffing and mandatory overtime charles mongare chamberlain university dr. todd buck april 19, 2023 nursing homes. Skip to document. ... Argumentative Paper. assignment paper. Course. Critical Reasoning (PHIL-347) 321 Documents. Students shared 321 documents in this course. University Chamberlain ...
Free【 Essay on Nursing Home 】- use this essays as a template to follow while writing your own paper. More than 100 000 essay samples Get a 100% Unique paper from best writers. ... An Argument in Enhancing The Care Quality in a Nursing Home. Information Nursing home companies. Genesis HealthCare; HCR ManorCare ...
Nursing home residents are not a homogeneous group. Accordingly, a wide range of needs and wishes are reported in the literature, assigned to various topics. This underscores the need for tailored and person-centered approaches to ensure long-term well-being and quality of life in the nursing home care setting.
87% of nursing homes experience moderate or high staffing shortages. 98% of nursing homes face issues hiring new staff. 73% of nursing homes may have to close due to staffing shortages. 60% of nursing homes are losing money. 53% of nursing homes cannot operate with their current costs and pace for more than a year.
First Opinion is STAT's platform for interesting, illuminating, and maybe even provocative articles about the life sciences writ large, written by biotech insiders, health care workers ...
Suddenly, Donald Trump looks enlightened about women. Sure, he's in a 1959 time warp, like some spray-tanned, comb-over swinger in a Vegas lounge, talking about skirts and broads. Sure, he ...
Old Age Homes.org is a directory of Elektrostal Old Age Homes for Aged Elderly Seniors People / Citizens of Elektrostal. It provides the information about various Old Age Homes in Elektrostal (Moscow Oblast) Russia and worldwide in an simplified way - country /state /city wise.
For artists, writers, gamemasters, musicians, programmers, philosophers and scientists alike! The creation of new worlds and new universes has long been a key element of speculative fiction, from the fantasy works of Tolkien and Le Guin, to the science-fiction universes of Delany and Asimov, to the tabletop realm of Gygax and Barker, and beyond.
Geographic coordinates of Elektrostal, Moscow Oblast, Russia in WGS 84 coordinate system which is a standard in cartography, geodesy, and navigation, including Global Positioning System (GPS). Latitude of Elektrostal, longitude of Elektrostal, elevation above sea level of Elektrostal.
Elektrostal Geography. Geographic Information regarding City of Elektrostal. Elektrostal Geographical coordinates. Latitude: 55.8, Longitude: 38.45. 55° 48′ 0″ North, 38° 27′ 0″ East. Elektrostal Area. 4,951 hectares. 49.51 km² (19.12 sq mi) Elektrostal Altitude.