bluuebunny/crossref_metadata_2025 huggingface dataset:
Evidence-Based Protocol
Authors: Enslein Janet , Tripp-Reimer Toni , Kelley Lisa Skemp , Choi Eunice , McCarty Laura
Published: May 2014

Interpreter Facilitation for ndividuals with Limited English Proficiency
Orlando's Deliberative Nursing Process Theory: A Practice Application in an Extended Care Facility
Authors: Faust Claire
Published: May 2014

When nurses undertake actions based on this validation process, the immediate needs of the patient are met, resulting in the ultimate goal of nursing- patient improvement
Nurses' and Family Members' PERCEPTIONS OF NURSING HOME RESIDENTS' NEEDS
Authors: Lindgren Carolyn L , Murphy Anne Marie
Published: May 2014

ABSTRACT

The purpose of this study was to determine the degree of agreement between nursing home staff and families in assessing the needs of cognitively impaired nursing home residents. A convenience sample of 36 family members of nursing home residents with cognitive impairment and the nurses assigned to those patients was recruited from three nursing homes. The Nurse and Resident Perceptions Questionnaire, adapted from Lindgren and Linton (1991), was used to assess functioning in activities of daily living, physiologic, and psychosocial areas. Significant differences were found for eight items of physiologic and psychosocial functioning: difficulties with chewing, swelling of feet, orthopnea, weakness, easy bruising, recognition of people, lack of privacy, and boredom. Nurses rated all these areas less problematic than did the family members. Collaborative efforts of family members and nurses are needed to develop effective plans of care for these problems of nursing home residents with cognitive impairment.
Perceptions of a Senior Citizens' Wellness Center: The Community's Voice
Authors: Hawranik Pamela , Pangman Verna
Published: May 2014

ABSTRACT

Health promotion encompasses an important role in the nursing care of all individuals across the life span. The literature indicates senior citizens tend to be the age group most actively involved in health promotion activities. Not only do senior citizens, as an age group, participate more frequently in health promotion activities, but also they tend to seek out health promotion opportunities. A center for community residing senior citizens, funded by the provincial health department for 4 years, was initiated to promote health and wellness among the senior citizens and to delay the onset of disability. To evaluate the outcomes of the Wellness Center, the qualitative methodology of this study used the focus group approach. The participants in the focus groups comprised health professionals and community groups with some involvement with the Wellness Center. In their discussions, participants identified the Center as providing health promotion services different from those currently existing in the health care system. The participants agreed the Center was essential to promote healthy lifestyles for senior citizens.
DEHYDRATION IN TERMINALLY ILL PATIENTS: Perceptions of Long-Term Care Nurses
Authors: Critchlow Jennifer , Bauer-Wu Susan M
Published: May 2014

ABSTRACT

Dehydration m terminally ill patients has been found to be beneficial and to improve the quality of an individual's last few days of life. As the population continues to age, more individuals are cared for in long-term care (LTC) facilities, where they tend to spend their final days. Previous studies have examined the perceptions and attitudes of hospice nurses, acute care nurses, physicians, and caregivers; however, no such studies have evaluated LTC nurses. It is necessary to know LTC nurses' perceptions and attitudes so they can be offered the eäucation needed to provide the best quality care for terminally ill patients. The purpose of this study was to describe how nurses working with elderly individuals in LTC perceived terminal dehydration (TD). Long-term care nurses (N = 64) were surveyed using a modified version of an established 10-item instrument. Significant findings included a positive correlation between age and positive perception of TD - as nurse age increased, a more positive view of TD was expressed. Also, the number of deaths witnessed was positively associated with the belief that TD was beneficial. In general, responses to the individual survey items were quite varied, representing inconsistencies in attitudes and care of dying LTC patients. The results of this descriptive study indicate the debate concerning the benefits of TD continues and remains an important topic for the LTC nurse.
Lessons from Mom's friends
Authors: Rahilly Linda B
Published: May 2014

Endnotes
Friends and Social Support in Dementia Caregiving: ASSESSMENT AND INTERVENTION
Authors: Lilly Mary LuAnne , Richards Beverly S , Buckwalter Kathleen Coen
Published: May 2014

ABSTRACT

The purpose of this article is to explore the topic of friends as a spontaneously occurring response in open-ended interviews with dementia caregivers and to propose guidelines for assessment and intervention based on current knowledge. The sample includes 176 open-ended baseline interviews with dementia caregivers from the National Caregivers Training Study, a 4-year multi-site, randomized, community-based, psycho-educational intervention study. References to friends were present in 60 of the 176 baseline transcripts. More than 50% of the references were positive, 63 % referred to the present, 80% of the content scores were greater than 1, and 66% were categorized as emotional support or social integration for caregivers. Meaningful categories exist and can be helpful in structuring the assessment of support from friends. Data support prior research suggesting that friends are providers and facilitators of emotional support and social integration. Although further research is needed on the concept of social support in general and social network providers in particular (e.g., friends), current knowledge allows for preliminary recommendations for assessment and intervention of friends and social support.
Training Family Caregivers of Patients with Dementia: A STRUCTURED WORKSHOP APPROACH
Authors: Ostwald Sharon K , Hepburn Kenneth W , Burns Theresa
Published: May 2014

ABSTRACT

The Minnesota Family Workshop consisted of seven weekly 2-hour sessions that provided education, family support, and skills training to primary family caregivers of patients with dementia, and other accompanying family members. The interdisciplinary faculty used a general stress and coping model to design the caregiver education program. To increase family involvement, the Minnesota Family Workshop required at least one other family member accompany the primary caregiver to the sessions. In addition, a concurrent adapted activity group was offered for the patients with dementia. This 14-hour curriculum with specific weekly objectives and activities detailed in this article was successful in reducing burden among caregivers of patients with dementia.
Conducting Research Related to Treatment of Alzheimer's Disease: Ethical Issues
Authors: Sevick Mary , McConnell Terrance , Muender Melissa
Published: May 2014

Cognitive impairments and the progressive nature of Alzheimer's disease can make researching a cure even more complicated.
Recognizing and Preventing Drug Interactions in Older Adults with HIV
Authors: McLennon Susan M , Smith Rachel , Orrick Joanne J
Published: May 2014

Older adults face the added challenge of drug interactions among HIV and AIDS medications and those used to treat conditions associated with aging.
BRIDGING THE IV GAP: Two Case Studies
Authors: Gilmore LuAnn , Jones Jeannie , Holman Crystal
Published: May 2014

When traditional therapies cannot provide the proper nutrition, peripheral parenteral nutrition may be the more tolerable way for older adults to overcome malnutrition.
Passive Therapeutic Gardens: A Study on an Inpatient Geriatric Ward
Authors: Pachana Nancy A , McWha J Lindsay , Arathoon Maureen
Published: May 2014

Gardening can produce physical and psychological health benefits for older adults in inpatient and assisted living environments.
Common Stressors Experienced by the Well Elderly: Clinical Implications
Authors: Stokes Shirlee A , Gordon Susan E
Published: May 2014

ABSTRACT

ABSTRACT

The purposes of the article are twofold - first, to report on a study that determined the 10 most commonly experienced stressors in individuals 65 years of age and older, and second, to present nursing interventions for each of the top 10 stressors. The research was conducted on a convenience sample of 200 healthy older adults living in the community using the Stokes/ Gordon Stress Scale. The two most commonly experienced stressors were slowing down and concern for world conditions. Others among the top 10 were constant or recurring pain or discomfort, time too short with children or grandchildren, and wishing parts of one's life had been different. Interventions discussed included careful planning of each day's activities, joining discussion groups on world events, participating in a political campaign, using e-mail and other technological communication methods, using reminiscence therapy, and implementing the use of various complementary therapies.

The purposes of the article are twofold - first, to report on a study that determined the 10 most commonly experienced stressors in individuals 65 years of age and older, and second, to present nursing interventions for each of the top 10 stressors. The research was conducted on a convenience sample of 200 healthy older adults living in the community using the Stokes/ Gordon Stress Scale. The two most commonly experienced stressors were slowing down and concern for world conditions. Others among the top 10 were constant or recurring pain or discomfort, time too short with children or grandchildren, and wishing parts of one's life had been different. Interventions discussed included careful planning of each day's activities, joining discussion groups on world events, participating in a political campaign, using e-mail and other technological communication methods, using reminiscence therapy, and implementing the use of various complementary therapies.
Medication Administration by Unlicensed Caregivers: A MODEL PROGRAM
Authors: Spellbring Ann Marie , Ryan Judith W
Published: May 2014

ABSTRACT

The assisted living housing option for older adults with limitations in activities of daily living presents a problem with medication administration. The purpose of this project was to expand the functions of the unlicensed caregivers in Group Senior Assisted Housing (GSAH) in Maryland. The caregivers and the GSAH providers or managers completed a 16-hour medication administration training program. Additionally, an oversight program using a delegating registered nurse (DRN) was established. The DRN verified the learning of the unlicensed caregivers, delegated medication administration (not including injections), and monitored this new care practice. Completion rate of the training program was 89% (N = 176). A high school education was significant in being successful. The oversight by the DRN was positively received by the caregivers, and it was clear oversight by the DRN was positively received by the caregivers, and it was clear that this was an essential part of the program. The project led to the first statewide that this was an essential part of the program. The project led to the first statewide regulations related to medication administration in assisted living.
Nursing Care of Transgendered Older Adults: Implications from the Literature
Authors: Berreth Margaret E
Published: May 2014

ABSTRACT

Although there has been considerable medical and psychological research into the phenomenon of transgenderism, little attention has been paid to issues specific to the older transgendered adult. This article seeks to address this gap by exploring issues relevant to the nursing care of the older transgendered adult. The specific topics covered include social support, abuse and neglect, medical concerns, and access to medical care. Resources for the transgendered older adult also are included. Journal articles and texts from nursing, medicine, and psychology are used. This review highlights implications for nursing, offers suggestions for promoting a therapeutic relationship in both the inpatient and outpatient setting, and concludes with areas for future research.
Self-Medication with over-the-counter Drugs Among Elderly Adults
Authors: Amoako Emelia P , Richardson-Campbell Lenora , Kennedy-Malone Laurie
Published: May 2014

ABSTRACT

Self-medication with over-the-counter (OTC) drugs is an economical choice of treatment for common self-limiting illnesses. As more medications are made available as OTC drugs, and as the population of older adults continues to increase, a need arises to monitor how elderly individuals use these agents. The purpose of this study was to assess the self-medication practices with OTC drugs among older adults. The study took place in a city in North Carolina in apartments managed by the city's Housing Authority and a private physician's office. Participants included 39 adults ages 59 to 91. Respondents lived independently, used OTC drugs, and were responsible for their health care decisions. Conn's Self-Medication Practice Tool was used to assess symptoms the older adults were treating with OTC drugs; therapeutic categories of OTC drugs used; frequency of OTC drugs used; and the use of alcohol, prescription drugs, and caffeine. The respondents reported pain as the symptom most frequently self-treated with OTC drugs. Ninety percent of the respondents used pain medicine, and approximately two thirds (67%) of the respondents used at least one high blood pressure medicine. More than half of the respondents (59%) used caffeine daily, and 10% used alcohol. The researchers concluded that older adults might be unaware of the adverse risks associated with concurrent use of pain medicines, alcohol, high blood pressure drugs, and regular caffeine use. This makes it necessary for all nurses and other clinicians providing health care to older adults to intensify efforts to educate and guard these patients and ensure appropriate use of OTC drugs.
The History of Advance Directives A Literature Review
Authors: Brown Barbara A
Published: May 2014

The Patient Self-Determination Act is one step needed to move to a more patient-centered health care system; nurses can aid in preserving patients' rights by helping older aduits develop advance directives.
Nursing Indicators of Quality in Nursing Homes
Authors: Harrington Charlene , O' Meara Janis , Collier Eric , Schnelle John F
Published: May 2014

A Web-based Approach

Websites can be helpful tools when evaluation nursing home quality if they evaluate the most important quality indicators
Behaviors of Older Men Living in the Community: CORRELATES PRODUCING ACTIVE COMPOSURE
Authors: Carter Kimberly Ferren
Published: May 2014

ABSTRACT

The correlates of active composure behaviors for older veteran men living in the community were investigated to identify this aspect of the complex domain of health behavior. Cox's (1982) Interaction Model of Client Health Behavior was used to frame this investigation. The independent variables were age, education, race, marital status, children, siblings, income, spiritual well-being, functional status, motivation, health conceptions, and loneliness. The dependent variable was Schwirian's (1992) active composure, conceptualized as activities producing rest, relaxation, and anxiety and stress reduction. The sample was male veterans (N = 184) older than 65 who were not living in an institution. A multiple regression model explained 49% of the variance in active composure. Race, income, religious aspect of spiritual well-being, instrumental activities of daily living, and loneliness were significant predictors. Results suggest that nurses may find these correlates helpful in facilitating the identification of risk status and developing active composure self -care strategies for older men living in the community.
The Significance of Losing Things: FOR NURSING HOME RESIDENTS WITH DEMENTIA AND THEIR FAMILIES
Authors: Powers Bethel Ann
Published: May 2014

ABSTRACT

This article examines the significance of losing things as part of an individual's whole experience with the material aspects of life. The data on which this report is based were drawn from a broader ethnographic study of everyday ethics affecting nursing home residents with dementia. Combined anthropological methods of participant observation and in-depth interviewing were used to gather information about ordinary daily issues for residents, family members, and nursing home staff. Findings are described as themes related to personal possessions and concerns surrounding them. Discussion comprises an interpretive analysis of meanings drawn from the research and represented as ethical considerations and practice implications - general principles and strategies.
Adult Day Programs: Who Needs Them?
Authors: Ross-Kerr Janet C , Warren Sharon , Schalm Corinne , Smith Donna Lynn , Godkin M Dianne
Published: May 2014

Nurses can identify older adults who may benefit from programs that provide the support necessary for them to continue living in the community.
Heart Failure in Older Adults: Providing Nursing Care to Improve Outcomes
Authors: Konick-McMahan Joanne , Bixby Brian , McKenna Catherine
Published: May 2014

ABSTRACT

Heart failure continues to be a challenge for older patients and their health care providers. This article is based on work by advanced practice nurses in a nursing study funded by the National Institute of Nursing Research of the National Institute of Health. Mary Naylor, RN, PhD at the University of Pennsylvania School of Nursing through grant #1RO1-NR04315 is using a transitional care model to provide advance practice nurse intervention for older adults with heart failure in a randomized controlled trial. Effects of the intervention being addressed include quality of life, functional status, rehospital izations, and costs of care.

Working with the patient in the acute hospital setting and following patients to the home care setting for 3 months, the advance practice nurse develops a visit pattern and intervention plan individual to the patient's needs. Key to a successful intervention plan is the right treatment for systolic versus diastolic failure. Although the patient's symptoms and some physical findings may be similar, the drugs used to treat systolic versus diastolic heart failure are different. Thus the nursing interventions to promote symptom management and avoid rehospital izations have a different approach.

In this article, care of elderly individuals with systolic versus diastolic heart failure is compared and contrasted using physical examination and diagnostic techniques, medication management, and nursing intervention. Case studies of a typical patient with systolic and diastolic heart failure will be used to illustrate the differences in approach to this common group of patients with complex needs.
What's New About Old Drugs
Authors: Linnebur Sunny A
Published: May 2014

Implications for the Care of Older Adults The information gained through clinical drug trials is valuable, and geriatric nurses must continue to update their knowledge in this area.
Planning HIV Education Programs for Older Adults: Cultural Implications
Authors: Rose Molly A
Published: May 2014

ABSTRACT

In this article the author discusses a needs assessment, through the use of discussion groups of various cultures, exploring the perceptions and attitudes of older adults about human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and HIV education. Five discussion groups (one with Latino older adults, two with African-American older adults, one with White older adults, and one with Chinese-American older adults) were conducted. Semi-structured guiding questions were used with all groups. The questions centered on three major areas: perceptions of older adults and HIV and AIDS, use of condoms for HIV and AIDS prevention, and HIV prevention programs for older adults. The group sessions were approximately 1 hour, were recorded on tape, and were transcribed. The sessions were conducted in the languages of the target population. Because the project was a needs assessment for program development, the number of participants in each cultural discussion group was small, and the nurse group leaders were not experienced in focus group methodology themes and generalizations cannot be made. However, specific findings from the group sessions and recommendations for HIV prevention are presented for further exploration.
Students and Senior Citizens Learning from Each Other
Authors: Fusner Sally , Staib Sharon
Published: May 2014

ABSTRACT

A service learning experience in a senior citizen center was planned for first-quarter associate-degree nursing students at a university. Activities were plan ned that would benefit both student learning and senior citizen health and well-being. Students had the opportunity to interact with wefl elderly adults before dealing with ill or frail elderly adults, thus preventing the formation of some negative attitudes about elderly individuals. Students practiced interviewing, using observational skills and taking blood pressures in a relaxed environment. Benefits to the senior citizens included having their blood pressure checked and learning about home safety and nutrition. Interactions made the senior citizens feel valued. Evaluation of the experience was positive from the students', senior citizens', faculty's, and center director's perspective. As a result, this service learning experience has been incorporated into the nursing curriculum for the university.
Diabetic Foot Care in a Long-Term Facility
Authors: Berry Rosa Maria , Raleigh Edith D Hunt
Published: May 2014

ABSTRACT

Foot problems continue to be a major cause of morbidity, disability, and mortality for individuals with diabetes. According to Rothman's model of causation, as interpreted by Pecoraro, Reiber, and Surges (1990), each amputation related to diabetes implies the existence of a completed causal pathway of predisposing factors. The purpose of this descriptive retrospective study was to evaluate foot care provided to residents in a 179-bed long-term care facility. The charts of all 17 eligible residents with a diagnosis of diabetes mellitus were reviewed for documentation of assessment and care of their feet. All data were collected by the investigator using the Minimum Data Set (MDS) 2.0 Assessment of Diabetic Foot Care Instrument and a demographic and foot care history instrument. Foot problems were documented for 59% of the participants. Podiatrist-documented foot examination was found in only one of the charts reviewed; however, six residents had been referred to podiatrist Throughout the charts reviewed, no documentation of protective sensation using the Semmes- Weinstein monofilament or vibration test was found. The findings of this study are consistent with previous research that showed a gap exists between the established standard and the degree to which the standards are met (Fain & Melkus, 1994; Wylie-Rosett et al., 1995). Adequate attention to the problem by health care providers, efforts to increase awareness of foot care standards, and early intervention may be steps to close the gap. Nurses must identify patients at risk for foot problems and actively intervene to prevent complications from occurring.
Medication Practices Among Chinese American Older Adults: A STUDY OF CULTURAL INFLUENCES
Authors: Zhan Lin , Chen Jie
Published: May 2014

ABSTRACT

The magnitude and intensity of medication use in older individuals have been widely discussed. Yet, a paucity of research data exists on medication practices among community-dwelling Chinese American older adults. This study examined factors associated with medication practices in community-dwelling Chinese American older adults. Data were collected through a descriptive survey. Chinese American older adults (n = 165) from the greater Boston area participated in the survey. The study revealed that ethnocultural barriers and a lack of health insurance significantly influenced medication practices among Chinese American older adults. The study suggested three important implications. First, more ethnoculturally appropriate health services are needed. Secondly, communication between clients and health providers must be improved. Finally, culturally sensitive medication management programs are needed.
GAMBLING BEHAVIORS in Black Older Adults: PERCEIVED EFFECTS ON HEALTH
Authors: Christensen Margaret H , Patsdaughter Carol A
Published: May 2014

ABSTRACT

Gambling is a popular activity among older adults of multiple ethnic and cultural backgrounds, but gambling research has not focused on elderly individuals or on minority groups. Although most gambling is a social activity, it also could have health implications for older adults. Sixty-seven Black individuals, ages 50 to 88, completed the Massachusetts Gambling Screen and 20 Black older adults were interviewed about gambling behaviors and beliefs about gambling and health. Although participants in this study were low income, they were as active in gambling as the general population. One pathological gambler and two problem gamblers were identified. The correlation between reported overall health and beliefs about the effects of gambling on health was not significant. Researchers, educators, and nurses working with older adults can help define the health implications of gambling on this population.
Decreasing Assault Occurrence on a Psychogeriatric Ward
Authors: Savage Troy , Crawford Ian , Nashed Yousery
Published: May 2014

An Agitation Management Model

ABSTRACT

An agitation management model providing staff education, quantitative assessment of agitation, and emphasized psychosocial interventions was introduced on a geriatric psychiatry ward for male patients. A within-subjects comparison was made of Cohen -Mansfield Agitation Inventory (CMAI) scores and frequency of committing assault under pre- and post-intervention conditions. Among participants (N = 8) who finished the 72week study, CMAI scores did not differ significantly under either of the study conditions (p > .05, two-tailed t test). Twenty-nine assaults occurred during the pre-intervention time period and six assaults occurred during the post-intervention time period. According to analysis with the Wilcoxon signed ranks test, the distribution of assaults differed significantly between the two time periods (p < .05, two-tailed). Among individuals who were excluded from the intervention because of lack of consent, assaults increased over the same two time periods. Psychosocial interventions intended to reduce agitation among elderly men with dementia may not necessarily serve to decrease agitation, but may serve to decrease assault occurrence.
Residents With DEMENTIA in Assisted Living Facilities: The Role of Behavior in Discharge Decisions
Authors: Aud Myra A
Published: May 2014

ABSTRACT

The purpose of this exploratory qualitative study was to identify behaviors that contribute to the decision to discharge the resident with dementia from an assisted living facility to a skilled nursing facility. Administrators of 14 assisted living facilities in Missouri were interviewed. The administrators were asked to describe occasions when residents with dementia were discharged. The findings of the study were based on analysis of the audiotapes of the interviews. According to the administrators, resident behaviors that influenced discharge decisions included behaviors indicating progression of dementia, behaviors indicating the need for more assistance with activities of daily living, incontinence, wandering, behaviors that did not meet the facility's expectations, behaviors reflecting changes in physical condition, and aggressive behaviors. These findings have implications for the role of nurses in assisted living facilities and for further research.
Beyond the Basics: Effects of the Eden Alternative Model on Quality of Life Issues
Authors: Bergman-Evans Brenda
Published: May 2014

ABSTRACT

In Life Worth Living, Thomas (1996) proposed that in long-term care facilities for elderly individuals, loneliness, helplessness, and boredom are out of control and are steadily decaying the residents' spirits, adversely affecting quality of life. While Thomas' contention appeals to common sense, no empirical evidence is offered in its support. The purpose of this quasi-experimental study was to assess the impact of implementation of the Eden Alternative model on levels of loneliness, boredom, and helplessness of older residents of a long-term care facility. The model was introduced into the experimental facility on May 1 , 1998. The final sample for the experimental group included 21 cognitively intact older adults from a state veterans home (13 men, 8 women, mean age = 76.1). The final control group was composed of 13 residents in a private long-term care facility (11 women, 2 men, mean age = 85.7). A Background Data Sheet, the Geriatric Depression Scale (includes yes or no questions related to helplessness and boredom), and the UCLA Loneliness Scale (Version 3) were administered by an interviewer at baseline and 1-year post-implementation of the Eden Alternative model. Data analysis from the post-implementation phase revealed significant differences between the groups on levels of boredom (z = -2.6, p = .01) and helplessness (z = -2.2, ? = .03). Lower levels of distress were found in the experimental group on both boredom and helplessness, but not loneliness. Findings suggest health care professionals and researchers have an opportunity to take a leading role in impacting services related to qualityof life issues for this important, but often overpopulation.
Warfarin Therapy in Older Adults: MANAGING TREATMENT IN THE PRIMARY CARE SETTING
Authors: Perrero Pam Perrin , Willoughby Deborah F , Eggert Julie A , Counts Sandra Harley
Published: May 2014

ABSTRACT

Oral anticoagulant therapy with warfarin is commonly used to prevent thromboembolic events in patients at risk. The degree of anticoagulation is variable among individuals and is influenced by many factors; therefore, patients must be monitored frequently to assess for potential adverse effects related to treatment. Individuals older than age 65 are at particular risk for thromboembolic events as well as anticoagulant-related complications. Because of these factors, elderly individuals pose a unique challenge in maintaining anticoagulant control. The purpose of this article is to revisit the role of warfarin therapy for elderly individuals in the primary care setting and to provide nurse practitioners with the information necessary to prescribe and monitor this medication appropriately. This article provides indications for warfarin therapy and also identifies potential barriers to effective management with specific implications for the older population.
TREATMENT OF Substance Misuse in Older Women: USING A BRIEF INTERVENTION MODEL
Authors: Finfgeld-Connett Deborah L
Published: May 2014

ABSTRACT

Alcohol and benzodiazepine misuse is a significant problem in older women for a number of reasons such as physiological changes, outdated prescribing practices, and failure to identify hazardous use. In addition, treatment barriers involving the health-care system, conflicting information, and ageism also exist. Substance misuse among older women is predicted to become a bigger problem as the baby boom generation ages. Brief interventions that consist of assessment, feedback, responsibility, advice, menu, empathy, and self-efficacy, or AFRAMES, have the potential to reduce alcohol and benzodiazepine misuse among older women in a cost-effective manner.
Older Married Couples and Health Promotion: Joint Decision-Making Process for Long-Term Spouses
Authors: Padula Cynthia A , McNatt Merrilyn
Published: May 2014

ABSTRACT

The purpose of this study was to explore communication patterns between long-term married couples to better understand the process by which later-life couples participate in health promotion. Forty community-residing couples married for 30 years or longer were asked to respond to open-ended questions and to participate in a decision-making activity. The majority of couples made health decisions jointly, with wives acting as the final deciders 54% of the time. Most couples used positive communication strategies during a structured scenario. Findings highlight the importance of expanding beyond traditional individual-focused models to include joint decision-making processes. Implications for future research and for nursing practice are discussed.
Predictors of LIFE SATISFACTION: Perceptions of Older Community-Dwelling Adults
Authors: Sparks Martha , Zehr David , Painter Brenda
Published: May 2014

ABSTRACT

The purpose of this study was to investigate variables that predict life satisfaction in elderly individuals. A convenience sample of 70 older community-dwelling adults participated in the study. Instruments used included the Life Satisfaction Index A Scale, three subscales from the Self-Evaluation of Life Function Scale, the Perceived Control Scale, Hollingshead's Two Factor Index of Social Position, and the Self-Rated Health Subscale of the Philadelphia Geriatric Center Multilevel Assessment Instrument. When the influence of health and social position was held constant, social interaction was the only additional significant predictor of life satisfaction. When health and social position were not held constant, social interaction, perceived control, and social position were significant predictors of life satisfaction. The findings indicate that nursing practice, education, and research should focus on assessment and interventions relative to promoting and maintaining health, perceived control, and social interaction among elderly individuals living in the community.
PHYSICIAN ORDERS for Life-Sustaining Treatment Form: Honoring End-of-Life Directives for Nursing Home Residents
Authors: Meyers Judy L , Moore Crystal , McGrory Alice , Sparr Jennifer , Ahern Melissa
Published: May 2014

ABSTRACT

The Physician Orders for LifeSustaining Treatment (POLST) form provides choices about end-of-life care and gives these choices the power of physician orders. The POLST form assures end-of-life choices can be implemented in all settings, from the home through the health-care continuum. The use of the POLST form was evaluated in a pilot study in nursing homes in two eastern Washington counties. Chart reviews and template analysis of interviews revealed the POLST form accurately conveyed end-of-life wishes in 19 of 21 cases. An informed consent process was evidenced in 16 of 21 cases, and the POLST form was congruent with residents' existing advance directives for health care. The findings support the continued use, development, and evaluation of this promising tool for improving end-of-life care.
Long-Term Care for Older Adults
Authors: Maas Meridean
Published: May 2014

Advocating for a New Health-Care Paradigm
Enhancing COMMUNICATION With Older Adults: Overcoming Elderspeak
Authors: Williams Kristine , Kemper Susan , Hummert Mary Lee
Published: May 2014

ABSTRACT

Gerontological nurses promote health and successful aging for a growing population of older adults. Care providers unknowingly may communicate messages of dependence, incompetence, and control to older adults by using elderspeak, a speech style similar to baby talk, that fails to communicate appropriate respect. This article describes a communication training program that significantly reduced the use of elderspeak by nursing assistants and led to more respectful, less controlling, and equally as caring communication between nursing assistants and nursing home residents. Strategies to use in evaluating and enhancing interpersonal communication with older clients are provided. Therapeutic communication is a critical tool for nurses who provide health care to the growing population of older adults.
AGGRESSION TOWARD STAFF By Nursing Home Residents: FINDINGS FROM A GROUNDED THEORY STUDY
Authors: Shaw Mary M Conlin
Published: May 2014

ABSTRACT

Aggressive behaviors by nursing home residents are common and can result in injury to both staff and residents. In addition, such aggressive behavior may lead to resident abuse by staff. This article describes a grounded theory study of nursing home staff response to aggressive residents and explores the problem of aggressive behaviors by nursing home residents, the conditions and context of aggression, and strategies staff use to prevent and manage aggression. To effectively deal with resident aggression, staff must become proactive, which involves three dynamic and interactive processes: practicing vigilance, intuiting, and strategizing. This article details these processes as well as the strategies staff use to deal with aggressive behaviors and makes specific recommendations for handling aggression toward staff.
Reducing the Incidence of PRESSURE ULCERS: Implementation of a Turn-Team Nursing Program
Authors: Hobbs Bradley K
Published: May 2014

ABSTRACT

This study examined the effects of a structured program designed to reduce pressure ulcers among patients in a midsized geriatric hospital. A select group of caregivers were organized into a "turn team" that was responsible for preventive pressure ulcer care. Patient and staff data were collected during a 6-month trial period. Subsequent analysis showed patient referrals to the staff enterostomal nurse and average length of stay, as well as musculoskeletal compensable injuries among all staff declined. In addition, concerns the program might lead to an increased incidence of nosocomial infections were not substantiated.
Touch-Stress Model and Alzheimer's Disease
Authors: Kim Eun Joo , Buschmann Marybeth Tank
Published: May 2014

Using Touch Intervention to Alleviate Patients' Stress

ABSTRACT

This article presents a theoretical model for future nursing research and practice on the use of touch intervention in patients with Alzheimer's disease. A theory synthesis was conducted that built on a base of previous research findings pertaining to the phenomenon of interest identified by two conceptual models: the Progressively Lowered Stress Threshold (PLST) model and the Touch model. The literature review was restricted to published articles in nursing and health services journals from 1970 through 2000. The Touch -Stress model formulated through theory synthesis can contribute to theory development, serve to improve care of patients with Alzheimer's disease suffering from emotional and behavioral disturbances, and increase the quality of life for the caregivers and families of patients with Alzheimer's disease.
CARE PLANNING for Nursing Home Residents: Incorporating the Minimum Data Set Requirements Into Practice
Authors: Taunton Roma Lee , Swagerty Daniel L , Smith Barbara , Lasseter Joyce A , Lee Robert H
Published: May 2014

ABSTRACT

This study was designed to describe the care-planning process used in nursing homes and identify links among care planning, care provided, and the Resident Assessment Instrument and Minimum Data Set (MDS). Study participants in three Midwestern nursing homes included residents and family members, MDS coordinators, direct care staff, administrators, directors of nursing, and medical directors. Data were collected via semi-structured interview, observation, and resident record audit. The care-planning process differed among the three facilities despite the common MDS system structure. Care planning and the MDS system were linked to the care provided to residents through documentation in residents' records, translation of the MDS care plan to the documents used for daily care, and ongoing communication through end-of-shift report and other venues.
The Wheat Valley Assisted Living Culture: RITUALS AND RULES
Authors: Al Omari Hasan , Kramer Kelli , Hronek Carla , Rempusheski Veronica F
Published: May 2014

ABSTRACT

This ethnographic study describes the cultural knowledge individuals use to organize their behaviors at one assisted living facility, Wheat Valley. Data were comprised of transcribed interviews with residents, family members, and staff; field notes of observations and informal interviews; and abstracted information from facility documents. The Wheat Valley culture is described as having six cultural categories, a single theme, a threat to the & culture, and a conceptualization of resident decision-making. The cultural description provides the basis for a discussion of practice implications.
BEYOND the Rhythm and Routine: ADJUSTING TO LIFE IN ASSISTED LIVING
Authors: Kennedy Diane , Sylvia Eldonna , Bani-Issa Wegdan , Khater Wejdan , Forbes-Thompson Sarah
Published: May 2014

ABSTRACT

In Western countries, demographic trends indicate an increase in the aging population well into the next century. Because of declining health, many older adults will benefit from residence in assisted living (AL). The purpose of this qualitative study was to explore the experience and contextual influences in everyday decision-making of four older adults in AL using a case study method. Several themes emerged as significant in older adult satisfaction with everyday decision-making (i.e., trigger event, level of physical functioning, inside and outside support systems, past patterns of decision-making). Strategies for assessing and strengthening these contextually relevant factors are discussed.
OSTEOPOROSIS: Health Beliefs and Barriers to Treatment in an Assisted Living Facility
Authors: Jachna Carolyn M , Forbes-Thompson Sarah
Published: May 2014

ABSTRACT

The purpose of this study was to describe residents' perceptions of osteoporosis and barriers to treatment in an assisted living setting. An exploratory, qualitative design was used. Five residents and the Director of Nursing participated in semi-structured interviews. Common health behaviors themes related to osteoporosis emerged that provide insight for nursing education and practice. The themes are discussed in light of the Health Belief Model, providing a framework for understanding osteoporosis-related health beliefs. This model lays a foundation upon which future interventions can be tested for effectiveness in improving osteoporosis-related care in assisted living.
Ethical Issues RELATED TO HEALTH CARE: The Older Adult's Perspective
Authors: Smith Katharine V
Published: May 2014

ABSTRACT

Although ethical issues in health care receive much publicity, attention is rarely given to the non-dramatic, everyday ethics of health care. This American Nurses' Foundation (ANF) funded pilot study was significant because it was the first to investigate everyday ethical issues from the perspective of older adult health care consumers. The overall goals of this descriptive study were to pilot interview questions and study design, as well as collect preliminary data about the ethical issues older adults in two settings (a residential facility and a non-residential community center) encounter related to health care. A sample of 10 participants answered several open-ended questions in an audiotaped interview; the tape was subsequently transcribed verbatim and analyzed using content analysis methods. Although two open-ended questions were effective in eliciting ethically related health care issues, the addition of specific examples to those questions was suggested. Health care related ethical issues identified by the older adults were categorized as Attentiveness, Respect, Care, Finances, and Health Care Systems. Although the residential participants did not experience financial issues as did the community participants, the highest priority issues for both residential and community participants were in the Attentiveness and Respect categories. The clinical implication of these findings is that nurses best address older adult health care consumers' most important ethical issues by providing attentive, respectful care in all they do.
PREVENTING FALLS in Acute Care: An Innovative Approach
Authors: McCarter-Bayer Annie , Bayer Fred , Hall Kathleen
Published: May 2014

ABSTRACT

Falls among elderly individuals have been significant sources of disability and death. Falls have affected as many as 10% of older adurtsduring an acute care inpatient stay. The acute care environment has contributed to elderly patient falls. Additionally, manifestations of acute illness, porypharmacy, and medication side effects have been risk factors for falls in the acute care setting. Individualized fall prevention strategies, initial patient assessments, and ongoing patient reassessments have been linked to a decrease in falls in the acute care setting. Approaches to fall prevention have included identification of high-risk patients, communication among staff and family members about an individual's risk of falls, and both case-specific and universal interventions for fall prevention. The purpose of this article is to describe a fall prevention program instituted in an acute care setting in southern Arizona that has produced encouraging results. Moreover, this article addresses individualizing interventions through a continuous clinical feedback loop, which provides patient care areas with relevant information about their patients who fell and recommendations for improving fall prevention.
HomeSafe
Authors: Schoenfelder Deborah Perry , Maas Meridean L , Specht Janet K
Published: May 2014

Supportive Assistance for Elderly Individuals Through a Nurse-Managed Plan
NURSE-PATIENT Communication IN DEMENTIA: IMPROVING THE ODDS
Authors: Perry Joann , Galloway Sharon , Bottorff Joan L , Nixon Sandra
Published: May 2014

ABSTRACT

This study investigates the use of a range of conversational strategies in a nurse-led socialization group with long-term care residents who have dementia. Eight residents whose Mini-Mental State Examination (MMSE) scores ranged from O to 19 participated in weekly group sessions for 10 weeks. All sessions were tape recorded and transcribed verbatim. Analysis of transcribed sessions resulted in two taxonomies: a taxonomy of nurse conversational strategies (clarifying, exploring, moderating, validating, rescuing, and general discourse markers) and a taxonomy of patient responses (discourse markers, limited engagement, expanded responses, personalized response, self-initiated participation, and disconnected or fragmented participation). The effectiveness of the nurse conversational strategies was reflected in the encouraging level of resident participation rates. The findings of this study suggest that with effective support and prompting, patients with advanced dementia are able to engage in social conversations beyond what would be expected given their diagnosis and MMSE scores.
Designing Written Medication Instructions: Effective Ways to Help Older Adults Self-Medicate
Authors: Hayes Karen
Published: May 2014

Delivering written medication instructions is a goal nurses can help fulfill by providing older adults with tools to retain information about why, how, and when to use their prescriptions.
Case Management for Patients with Heart Failure: A QUALITY IMPROVEMENT INTERVENTION
Authors: Miller Louise C , Cox Karen R
Published: May 2014

ABSTRACT

At-home case management is one strategy for improving quality of care for elderly patients with heart failure. Essential components of an effective heart failure case management intervention include frequent patient contact with the case manager and vigilant at-home monitoring of symptoms with responsive modifications to the treatment plan. It is just as important that the health care system (e.g., the acute care institution) is committed to assuring administrative support, financial backing, and dedicating clinical expert resources to achieve clinical quality improvements. In this article, the design, implementation, and outcomes of an at-home heart failure case management program are described, and challenges faced in implementing and sustaining the program are outlined.