bluuebunny/crossref_metadata_2025 huggingface dataset:
HYPODERMOCLYSIS THERAPY IN A CHRONIC CARE HOSPITAL SETTING
Authors: Worobec Fran , Brown Mary K
Published: May 2014

Occasionally, elderly patients experience acute, episodic incidents of illness that result in dehydration or a high potential for dehydration (e.g., flu, diarrhea). At times, patients may be unable, or refuse, to take fluids orally. Enteral routes via a nasogastric tube or enteral stomach tube may also not be available. In the past, these patients often had to be transferred from home or long-term care facilities to an acute care hospital for intravenous therapy. A transfer of the acutely ill elderly patient to an acute care hospital is often very stressful to the patient and his/her family and is costly to the health care delivery system. Hypodermoclysis, the process of rehydrating a patient by providing isotonic fluids into the subcutaneous tissues over a short time period, provides an alternative method to deal with acute, short-term fluid deficit problems in the elderly. Hypodermoclysis therapy can be administered in a chronic care setting thus potentially decreasing the need to transfer the elderly client to an acute care hospital. The purpose of this study was to investigate the use of hypodermoclysis therapy in solving acute, or potentially acute fluid deficit problems, that were anticipated to be both reversible and short term in nature. This was carried out in an elderly population that resided in a 284-bed chronic care hospital in southern Ontario.
EXPANDING THE SCOPE OF CONTINUITY THEORY Application to Gerontological Nursing
Authors: Onega Lisa L , Tripp-Reimer Toni
Published: May 2014

ABSTRACT

Continuity Theory is a psychosocial theory of aging which posits that as middle-aged and elderly adults adapt to changes associated with the normal aging process, their past experiences, decisions, and behaviors will form the foundation for their present and future decisions and behaviors. Regardless of the clinical setting, nurses working with elderly individuals may find Continuity Theory helpful in viewing the experience or elders in a holistic way that incorporates a life course perspective. By applying Continuity Theory to clinical practice, nurses may be better able to provide individualized, clinically appropriate care to elders.
Planning for the Future of Long-Term Care: Consumers, Providers, and Purchasers
Authors: Beck Cornelia , Chumbler Neale
Published: May 2014

The number of people needing nursing home core during the next 30 yeors is expected to triple.
MANAGED CARE: What is its Impact on Nursing Education and Practice?
Authors: Malloy Catherine
Published: May 2014

ABSTRACT

Market forces present the nursing profession with an urgency to prepare gerontological nurses to assume significant roles in the managed care industry. An understanding of the current managed care environment underscores the need for training. Nurses require a "managed care" skill-set encompassing a firm grasp of the organization, financing, delivery, and policy implications of managed care as well as advanced practice clinical skills and a sound business orientation. The importance of the consumer as a significant player in managed care is highlighted.
THE FAMILY'S ROLE IN LONG-TERM CARE
Authors: Robinson Karen M
Published: May 2014

Abstract- Long-term care provided by family members is the central core of our current health care system. The purpose of this artkle is to review the family's role in long-term care. Issues such as cost containment and inequities in our current social policy are reviewed. Suggestions for future directions in social policy are presented.
LEARNING FROM OTHER LANDS CARING FOR ELDERLY DEMENTED KOREANS
Authors: Lee Haeok , Kim Susie , You Kwang-Su
Published: May 2014

The aims of the study reported here were to describe the socio-demographic characteristics of caregivers of demented elders in Korea and their care recipients and to compare the positive and negative meanings and outcomes of the caregiving experiences of caregivers who had admitted their elderly demented relative to a nursing home (Gl : n=24) and caregivers still caring for their elderly demented relatives at home (G2: n=30). Most caregivers were female (80%), married (89%), and related to the care receiver as daughter-in-law (39%), daughter (22%), wife (15%), son (13%), or neighbor (6%). Social class differences were found between the home care and nursing home groups: the upper classes were significantly more likely to have placed their demented elder in a nursing home, whereas the low social classes were more likely to keep taking care of their demented elder at home instead of placing them in a nursing home. Caregivers who had admitted their relative to a nursing home (Gl ) reported significantly more difficulties from disturbed sleep, disrupted children's studies, and limited personal life when they were caring for the elder at home (pK.05). Caregivers in the home care group (G2J had significantly greater satisfaction in serving as a model for their children and practicing religion (pc.05), and they also repotted a better relationship with the care receiver than those who have placed their demented elder in a nursing home, although the difference in this case was not significant.
TRENDS IN AGING CARE SCOTLAND AND SCANDINAVIA
Authors: Evans Lois K
Published: May 2014

ABSTRACT

The proportion of older adults in Western European countries, as in the United States, continues to increase rapidly. Faced with geriatric care dilemmas decades earlier, however, these countries have had more experience on which to base lhe development of community- based, integrated care systems for the elderly. This article provides observations from a 1993 World Health Organization Fellowship study of long-term care facilities in four European countries: Scotland, Sweden, Norway and Denmark. Several emerging trends in geriatric care documented in the literature were confirmed. These included: moratoria on institutional long-term care, emphasis on informal care and support, provision of 24-hour assistance in the home, care management to individualize care, and an expanded set of providers within integrated delivery systems.
RESIDENT RIGHTS: Knowledge of and Implementation by Nursing Staff in Long-Term Care Facilities
Authors: Roberto Karen A , Wacker Robbyn R , Jewell Eva M , Rickard Mindy
Published: May 2014

ABSTRACT

in this study, we assessed the differences between certified nursing assistants' (CNAs) and nurses' (RNs and LPNs) level of knowledge and perceived implementation of resident rights. The CNAs and nurses responded to a series of 1 1 scenarios representing rights such as privacy, choice, and respect. Their responses suggested that although they knew what the appropriate response to the situation was, it was not the typical response to that type of situation within their facilities. Implications for teaching and applying resident rights are discussed.
A Team Approach to Dynamic Programming ON THE SPECIAL CARE UNIT
Authors: Buettner Linda L
Published: May 2014

Abstract: The link between boredom, agitation, and therapeutic programming for individuals with dementia is a strong one. Research indicates that carefully planned activities can have a powerful impact on behavior, functioning, and mood of residents. Interdisciplinary staff involvement, careful assessment of residents' needs and interests, and the use of both diversional and therapeutic activities programs are examined in this article.
Changes in Health Status of Elderly Patients Following HIP REPLACEMENT SURGERY
Authors: Brodie Lyndell J , Sloman Rodney M
Published: May 2014

ABSTRACT

This study investigated changes in health status following a total hip replacement among a convenience sample of 22 male and 23 female patients, all of whom had been suffering from hip dysfunction and associated arthritic pain and impaired mobility. Subjects were pretested in an orthopedic pre-admission clinic with the Arthritis Impact Measurement Scales questionnaire and were posttested with the same instrument 3 ½ months after the initial contact and subsequent to hip replacement surgery. Analysis of pretest and posttest mean differences showed significant improvement in scores for pain and physical activity. No significant changes were demonstrated in the psychological and social domains of health status.
FILIAL PIETY
Authors: Dai Yu-Tzu , Dimond Margaret F
Published: May 2014

A Cross-Cultural Comparison and its Implications for the Well-Being of Older Parents

ABSTRACT

The purpose of this article is to compare and contrast the concept of filial piety in Chinese culture and American culture and to discuss the relationship between expectations of filial piety and the well-being of older adults. In both cultures, filial piety is a socially approved virtue and contains attributes of respecting, caring for, and loving the parents. The differences include: obedience versus confrontation of parents; limited versus unlimited responsibility to parents; and a difference in the concept of legitimate support. Based on previous literature, the relationship between the expectations of filial piety and parents' well-being was explored, and nursing implications were suggested. Nonetheless, there is no single intervention that could fit all clients from one culture. Nurses need to examine to what extent clients value their culture of origin.
Special Care Units for People With ALZHEIMER'S DISEASE: Only for the Privileged Few?
Authors: Maas Meridean L , Specht Janet P , Weiler Kay , Buckwalter Kathleen C , Turner Betty
Published: May 2014

ABSTRACT

The number of Special Care Units (SCUs) for people with Alzheimer's disease (AD) in nursing homes have increased dramatically in the past 10 years. Despite the rapid increase in number of SCUs and the concern that most SCUs report higher costs than traditional nursing home units where residents with AD are integrated with cognitively intact residents, the evaluation of costs has been largely unsystematic and noncomparative. Studies are urgently needed to assess comparative costs so that administrators and policy makers can make informed decisions. This article reviews studies that examine the costs of care in SCUs and presents cost-related data comparing the outcomes of care for residents with AD on a SCU and on traditional units in one long-term care setting.
Merging Regulations and Recommendations
Authors: Kramer Joan
Published: May 2014

How Can the Best Outcomes be Achieved?
Nursing Home Dementia Care Units PROVIDING A CONTINUUM OF CARE RATHER THAN AGING IN PLACE
Authors: Kovach Christine R
Published: May 2014

ABSTRACT

Experience from the first 24 months of a new Dementia Special Care Unit is presented with an emphasis on admission and discharge criteria, length of stay, and reasons for discharge. Maintaining residents with moderate functional abilities on a Special Care Unit is examined relative to relocation stress, aging in place, and staff needs. The benefits of providing a continuum of dementia care and the risk of potential harm of frequent intra-institutional moves are discussed.
EFFICACY BELIEFS IN GERIATRIC REHABILITATION
Authors: Resnick Barbara
Published: May 2014

ABSTRACT

Motivation is an important variable in older adults' ability to recover from any disabling event. The theory of self-efficacy states that efficacy beliefs affect behavior, motivational level, thought patterns, and emotional reactions in response to any situation. This study explored the impact of efficacy beliefs on older adults in a rehabilitation program and tested interventions to strengthen efficacy beliefs related to participation in rehabilitation and functional performance.

An experimental ? retest- posttest design was used. Participants were randomly assigned to: the usual care control group or the treatment group. The study was completed on an inpatient geriatric rehabilitation unit. The sample consisted of 77 participants, 55 women and 22 men with a mean age of 78 ± 7.2. Individuals in the treatment group received three efficacy enhancing interventions: role modeling, verbal persuasion, and physiological feedback. Baseline data were collected within 48 hours of admission and included four investigator-developed efficacy measures: Functional Inventory Measure, Participation Index, Numeric Rating Scale for pain, amount of analgesic used for pain, and Health Status. With the exception of Health Status, these measures were again completed within 48 hours of discharge.

Admission performance was the only statistically significant predictor of efficacy beliefs. All efficacy beliefs increased over time and were significantly correlated with performance behaviors and length of stay. The treatment group had stronger efficacy beliefs regarding participation, higher participation at discharge, and less pain than the control group.

Efficacy beliefs, both self-efficacy and outcome expectations, are related to participation, functional performance, and length of stay. Interventions to strengthen these beliefs improved participation in rehabilitation and decreased pain. Consideration of motivation can facilitate rehabilitation and help older adults obtain and maintain their highest functional level.
Older? Who me?
Authors: Barry Richard , Burggraf Virginia
Published: May 2014

Growing Old Should Not Mean Giving Up
Pain & Cognitive Status in the Institutionalized Elderly
Authors: Kaasalainen Sharon , Middleton Joan , Knezacek Sandy , Hartley Terry
Published: May 2014

ABSTRACT

The purposes of this study were t examine the relationship between: (1) nurses' ratings of pain and corresponding administration of pain medication to elderly long-term care residents, and (2) cognitive status the elderly and pain medication orders/administration. Participants were 83 residents, 60 years of age and older, in two groups: cognitiveIy impaired (n = 64), and cognitively intact (n = 19). For comparison purposes, 19 of the cognitively impaire subjects were matched on age an diagnosis to provide control fi potentially painful conditions. A retrospective medication review of the residents' charts was conducted to compare medication orders and administration on analgesics that were scheduled and p.r.n. (given needed). The pain ratings of 25 RN using a visual analogue scaie wen correlated with pain medication given to the resident on the day o the rating. Results indicated that RNs' ratings of resident pain and the administration of pain medications were not significantly correlated. In addition, cognitively impaired residents were prescribed significantly less scheduled medication and received significantly less pain medication (either p.r.n. or scheduled) than the cognitively intact elderly. Implications for practice and research are discussed.
EXAMINING PAIN in Aggressive Cognitively Impaired Older Adults
Authors: Feldt Karen S , Warne Mary A , Ryden Muriel B
Published: May 2014

ABSTRACT

Few studies have explored the phenomenon of pain in people with severe cognitive impairment. Pain assessment, which depends primarily on people's ability to describe dimensions of pain, becomes problematic when clients' cognitive impairment is so severe they cannot respond to pain assessment tools. The purpose of this study was to describe the phenomenon of pain for a subgroup of aggressive cognitively impaired nursing home residents who were enrolled in a larger study of aggressive behavior. To determine if pain was a possible factor influencing aggression, information was sought from five sources: family members, nursing assistant (NA) caregivers, medical record listings of pain-related diagnoses, use of analgesics, and observations of aggressive behaviors. Families reported pain in 44% of subjects, while NAs reported pain in 66% of subjects. Seventysix percent of subjects had one or more pain-causing diagnoses. Sixty-four percent of subjects whose family members thought they may have pain were being treated with analgesics, compared to 44% of subjects whose NA reported they may be experiencing pain. Aggression scores were significantly higher in subjects who had two or more pain-related diagnoses and in subjects with arthritis. Nurses who are aware of a history of pain, reports of pain by families and caregivers, presence of pain-related medical diagnoses, and who realize pain may be a trigger for aggressive behavior may be more likely to recognize pain in cognitively impaired older adults. Better pain assessment should lead to improved treatment of pain in this population.
Entering the World of DEMENTIA
Authors: Anderson Mary Ann , Wendler M Cecilia , Congdon JoAnn G
Published: May 2014

CNA Interventions for Nursing Home Residents
Individualizing Medication Regimens for Older Adults
Authors: Bergman-Evans Brenda , Ranno Anthony
Published: May 2014

Gerontological nurses play a key role in ensuring older adults receive appropriate drug therapy
UNMET HEALTH CARE NEEDS: Comparison of Rural and Urban Senior Center Attendees
Authors: Clark Darlene , Dellasega Cheryl
Published: May 2014

ABSTRACT

Rural-dwelling older adults are in poorer health and have less access to health care resources than urban older adults. However, little is known about specific unmet needs which exist for urban and rural populations. This study compared self-reported health status, use of services, and unmet health care needs of 106 elderly individuals residing in rural and urban settings to determine if these variables differed based on geographic location.

Data were gathered on the three dependent measures using the Elderly Health Care Needs Assessment Questionnaire. Findings revealed rural older adults were not in poorer self-reported health (x2 = 1.85, p = .60). However, a t test showed rural subjects were significantly poorer in objective health as measured by the number of reported symptoms (t = 224, p = .02). Despite having a greater number of specific heath complaints, these rural elderly individuals did not use significantly more services (t = 1.16, p = .24) or report more unmet needs (x2 = 3.67, p = .055), thereby reinforcing traditional views of rural older adults being in poorer health but also more self-reliant in matters related to health care.

The results of this study provide information which will improve nursing practice in rural and urban settings and provide direction for further research.
When TRADITIONAL Care Falls Short
Authors: Hall Geri Richards
Published: May 2014

Caring for People With Atypical Presentations of Cortical Dementia
Developing Individualized Care in Nursing Homes
Authors: Walker Leslie , Porter Martha , Gruman Cynthia , Michalski Marion
Published: May 2014

Integrating the Views of Nurses and Certified Nurse Aides

ABSTRACT

Despite recent attention devoted to the development of individualized care in nursing homes, empirical research assessing changes in practice is quite limited, and very few studies have explored specifically the experiences and perceptions of certified nurse aides (CNAs). This study reports findings from a comparative analysis conducted on a data set including quantitative and qualitative data from CNAs (N = 289) and nurses in Connecticut (N = 245). Measures of obstacles to individualized care and needs for future supports were explored. A number of significant differences in perceptions of obstacles to providing individualized care were found. The nurses were significantly more likely to identify the following impediments to change: cost (p < .0001), concepts not integrated into work (p < .0001), lack of administrative support (p < .10), and staff attitudes (p < .10). The CNAs were significantly more likely to report inadequate staffing (p < .001), lack of interdisciplinary teams (p < .001), and resident and family attitudes (p < .01) as problematic. These findings suggest substantial discordance among nurses and CNAs on a number of important issues surrounding individualized care. Such disparate perceptions pose challenges to nursing homes committed to the implementation of individualized care alternatives. Successful approaches must consider the various vantage points of caregivers and administrators.
BLADDER DIARIES and Voiding Patterns Older Adults
Authors: Pfister Susan M
Published: May 2014

ABSTRACT

Urinary incontinence is one chronic health problem that many older adults experience. Assessment is the first step in approaching a urinary elimination problem and forms the basis for determining potential management modalities. The bladder diary, one type of fluid intake and output record, is helpful in describing an individual's voiding pattern and is an integral component of urinary assessment. Bladder diaries also can be used to evaluate the effectiveness of interventions initiated to manage incontinence. This article describes the procedure for using bladder diaries within the context of a research study conducted with residents of retirement settings.
Evaluation and Management of Orthostatic Hypotension in Elderly Individuals
Authors: Kunert Mary Pat
Published: May 2014

Attention to blood pressure when changing positions may prevent life-threatening falls and increase independence
IS COGNITIVE IMPAIRMENT a Guide to Use of Video Respite™?: Lessons From a Special Care Unit
Authors: Malonebeach Eileen E , Royer Mark , Jenkins Cathleen C
Published: May 2014

ABSTRACT

The goal of this study was to examine the usefulness of Video Respite™ (VR) in relation to the abilities of cognitively impaired older adults. Three VR videotapes were shown to residents of a special care unit. Older adults were videotaped as they viewed the VR videotapes to observe their levels of involvement. Analyses of the videotapes of the older adults confirmed that participation varies considerably between and within residents and, further, that cognitive status is not a useful guide in predicting levels of participation. Some residents showed no interest in television in general or in VR, while the elimination of distractions resulted in more sustained viewing for those inclined to participate. The authors' observations suggest ways to optimize the usefulness of VR for formal and informal caregivers.
Pain Assessment in Older Adults Who Are Cognitively Impaired
Authors: Galloway Sharon , Turner Linda
Published: May 2014

Dementia may cause a barrier to communication; therefore, behavioral indicators and familiarity with patients are valuable in assessing and treating pain in this population.
WANDERING: A Dementia-Compromised Behavior
Authors: Algase Donna L
Published: May 2014

ABSTRACT

The wandering behavior of individuals with dementia is a puzzling behavior, and strategies for responding to it often are poorly grounded. However, advances in the understanding of neurocognitive factors contributing to wandering now may provide important clues for designing nursing approaches, in this article, such advances are summarized, and implications and strategies for practice are delineated.
FAMILY PERSPECTIVES on Dying in Long-Term Care Settings
Authors: Wilson Sarah A , Daley Barbara J
Published: May 2014

ABSTRACT

Dying is a central experience in the life of a family. Yet there are few studies of dying in longterm care and the role of a family. The dynamic relationships among families, staff, and residents in long-term care facilities related to the process of dying is an area where research is needed. As part of a larger study of death and dying in long-term care settings, 11 family members who recently had experienced the loss of a relative in the long-term care setting were interviewed. The purpose of this study was to describe family perspectives on death and dying in long-term care facilities and to discuss ways staff may be helpful to families in coping with the loss of a family member. Analyzing death and dying from the family perspective offers health care providers an opportunity to expand the understanding of the phenomenon of death in long-term care facilities and to incorporate care activities that families view as helpful. Major themes emerged from this study, including the caring behaviors of staff, participating in the dying process, and providing spiritual support. The themes and practice implications are discussed in this article.
Deceiving Appearances: Communicating With Facially Inexpressive Older Adults
Authors: Schulman-Green Dena J
Published: May 2014

Physical conditions may cause a loss expressive abilities, but effective interaction requires nurses to assume patients are cognizant and to rely on nonverbal cues and intervention strategies.
Older Women and the Meaning of Health
Authors: Maddox Margie
Published: May 2014

ABSTRACT

Health promotion has become an essential component of comprehensive health care, especially considering the growing female population. Older women, in particular, have demonstrated an increasing need for preventive services or health care maintenance and promotion. These needs consist of services provided by health care professionals that can help women meet their own self-care demands. However, before the health care needs of women can be met, they first must be identified.

Using Orem's Self-Care Theory, a three-part qualitative phenomenological study was conducted in an attempt to understand what health actually means to older women and what types of health behaviors they feel are important to maintain or promote health. Three different groups of women age 55 and older with a variety of education, socioeconomic, and racial backgrounds were interviewed. Their responses were analyzed carefully, and each participant was interviewed a second time to validate recurrent themes regarding their statements about health.

Results of the interviews with the three different groups of women were surprisingly similar. Although each participant had a unique application of their definition of health, there were five recurrent themes identified by 75% to 80% of the women. The themes were interactions with a being greater than themselves, acceptance of self, humor, flexibility, and being other-centered. Numerous examples supported the five themes. In addition, several "healthy behaviors" also were identified. Based on the findings of this 3-year study, older women seem to have their own perspectives on what health actually means and how they can best monitor or maintain their health. While the list is slightly different than the traditional one prescribed by health care professionals, perhaps it is time to encourage older adults to become more of a partner in their care. These healthy behaviors could be incorporated easily into the treatment and management plans and thereby reflect both parties' definitions of what it means to be healthy. Health care professionals must continue to ask older adults about their view of health and encourage their partnership in healthrelated issues. All individuals, no matter what age, are being encouraged to assume more responsibility for their own personal health, and by including older adults in the decision-making process, this partnership can be strengthened.
Alcohol Use in Elderly Women: Nursing Considerations in Community Settings
Authors: Ludwick Ruth E , Sedlak Carol A , Doheny Margaret O , Martsolf Donna S
Published: May 2014

Assessment of alcohol intake should be routine for elderly women and screening tools should be used when misuse is suspected.
Understanding What MOTIVATES Older Adults to Exercise
Authors: Resnick Barbara , Spellbring Ann Marie
Published: May 2014

ABSTRACT

The purposes of this study were to explore the factors that influenced adherence to an exercise program for older adults, and compare differences in motivation, efficacy expectations, health status, age, functional performance, and falls between adherers and nonadherers. A combined qualitative and quantitative design was used. Participants included 23 of the 24 members of an existing walking group, with an average age of 81 ± 7.2 years. Fourteen (60%) participants did not adhere to walking, while 9 (40%) adhered. Those that adhered had fewer functional limitations due to their health, (F = 7.7, p < .05), better functional performance (F = 4.0, p < .05), stronger self-efficacy expectations related to exercise (F = A3, p < .05), and fewer falls (F = 4.4, p < .05). Six major themes were identified that impacted adherence: a) beliefs about exercise; b) benefits of exercise; c) past experiences with exercise; d) goals; e) personality; and f) unpleasant sensations associated with exercise. Interventions that focus on teaching older adults about the benefits of exercise, establishing appropriate goals, and decreasing unpleasant and increasing pleasant sensations associated with exercise may be useful to improve adherence to a regular exercise program.
A Fall Prevention Program For Elderly Individuals: Exercise in Long-Term Care Settings
Authors: Schoenfelder Deborah Perry
Published: May 2014

Walking and strength training are examples of effective strategies to offset declining strength and improve balance, thus reducing falls and promoting well-being.
PREDICTORS of Early Hospital Readmissions of Older Adults Who Are Functionally Impaired
Authors: Schwarz Karen A
Published: May 2014

ABSTRACT

When older adults who are chronically ill are discharged home, they face a high risk of hospital readmission. The purpose of the study was to determine whether low social support, low satisfaction with social support, high depressive symptomatology of the caregiver, and minimal use of home health care predicted hospital readmissions of the older adult. Sixty family caregivers were interviewed in their homes soon after hospital discharge and 3 months later. Tangible forms of social support and helping others were negatively related to the number of hospital readmissions. Nurses need to encourage families to seek and use social support that is offered.
Alzheimer's Dementia: Coping with Communication Decline
Authors: Hendryx-Bedalov Patricia M
Published: May 2014

ABSTRACT

Communication difficulties in patients with Alzheimer's dementia are a major source of caregiver strain because of the psychological and interpersonal burden they present. Nurses are in a critical position for understanding the communication decline and providing education and counseling to decrease this burden. In this article, the communication burden of dementia is examined and practical approaches to facilitating communication are discussed so nurses can increase their role in education and counseling regarding Alzheimer's dementia.
A Case Study of the Death of an Older Woman in a Nursing Home: Are Nursing Care Practices in Compliance With Ethical Guidelines?
Authors: Kayser-Jones Jeanie
Published: May 2014

ABSTRACT

This article presents a case study describing and analyzing ethical issues in the care during the last 1 1 weeks of life of a 101 -year-old nursing home resident. The case presented here is part of a larger ongoing ethnographic study of death and dying in nursing homes. Two nursing care issues with ethical implications are discussed. First, the resident could not eat or drink independently, but she received no assistance with her meals. Second, she remained in a wheelchair for many hours and developed three pressure ulcers on her buttocks. Furthermore, she became tired when sitting in the wheelchair for long periods of time, fell out of the wheelchair, and subsequently was restrained "for her safety." Using selected principles from the International Council of Nurses and the American Nurses Association code for nurses, the resident's care is discussed and recommendations for improving the care of nursing home residents are presented.
Stressors, Social Support, Coping, and Health Dysfunction IN INDIVIDUALS WITH PARKINSON'S DISEASE
Authors: Backer Jane H
Published: May 2014

ABSTRACT

The purposes of this descriptive correlational study were to describe the illness-related stressors of individuals with Parkinson's disease and to report the extent to which social support and coping responses predict physical and psychosocial health dysfunction. The sample consisted of 70 men and women, age 44 to 80, residing in the community. Participants reported a variety of illnessrelated stressors, most of which occurred on a daily basis and involved some loss in functional abilities. Less perceived availability of social support, more evasive coping, and more confrontive coping predicted greater health dysfunction, suggesting that these factors may be important to consider when assessing individuals with Parkinson's disease and designing interventions for individuals with functional declines.
Guidelines for Stage-Based Supports in Alzheimer's Care: The FAST-ACT
Authors: Connolly Debye Macdonald , Pedlar David , MacKnight Chris , Lewis Colby , Fisher Joan
Published: May 2014

Nurses should use support services to prevent excess disability in patients and promote physical and psychological well-being in caregivers.
MSHAKE: A tool for Measuring Staff Knowledge Related to Geriatric Mental Health
Authors: Santo-Novak Debra A , Duncan Jeri W , Grissom Kathy R , Powers Richard E
Published: May 2014

ABSTRACT

This article describes the development of a knowledge-screening instrument used with staff caring for elderly patients with neuropsychiatrie disability. A 25-item tool, referred to as the Mary Starke Harper Aging Knowledge Exam (MSHAKE), was developed to verify knowledge competencies of 171 employees at a gero psychiatric center in the Southeastern United States. The MSHAKE assesses basic geriatric mental health knowledge in an educationally diverse health care work force. A variety of descriptive and inferential statistics provide preliminary evidence supporting the use of the MSHAKE as an effective measure of staff members' essential knowledge of aging and neuropsychiatrie disorders. This tool has practical application in the clinical setting as part of a competency verification system or in-service evaluation.
Training of Acute Confusion Resource Nurses
Authors: Rapp Carla Gene , Onega Lisa L , Tripp-Reimer Toni , Mobily Paula , Wakefield Bonnie , Kundrat Mary , Akins Jackie , Wadle Karen , Mentes Janet C , Culp Kennith , Meyer Jean , Waterman James
Published: May 2014

Knowledge, Perceived Confidence, and Role
Patterns of Telephone Use Among Nursing Home Residents
Authors: Gueldner Sarah Hall , Smith Carol A , Neal Maryanne , Penrod Janice , Ryder Janice , Dye Maryellen , Bramlett Martha Haines , Hertzog Leeann
Published: May 2014

ABSTRACT

There is convincing evidence that nursing home residents who have more visitors fare better than those who have fewer visitors. However, as many as one third of all individuals living in nursing homes have virtually no visitors. The purpose of this study was to address this concern by examining telephone use in older adults living in nursing homes, and evaluating the potential of telephone communications as a means of social support for this at-risk group. Using a recording device activated each time the receiver was picked up, the research team "listened in" on the telephone conversations of three nursing home residents (aged 76, 79, and 92) for a period of 1 week. The transcripts revealed 56 minutes of actual conversation during the week (10, 21, and 25 minutes, respectively), most often with family or longtime friends living out of town. Each resident laughed aloud more than once per minute. The telephone conversations provided the residents with vivid glimpses of life outside the walls of their facility and appeared to help them stay connected with their family and friends. The findings support further study of the telephone as a way to sustain authentic social support in long-term care populations.
THE OLDEST-OLD: How Do They Differ from the Old-Old?
Authors: Field Dorothy , Gueldner Sarah Hall
Published: May 2014

ABSTRACT

This article reviews findings from the Berkeley Older Generation Study, a long-term longitudinal study of aging. The findings show many important differences between the oldest-old age group and other, younger-old individuals. Marked variation is demonstrated in the verbal scale of intelligence. More than half of oldest-old individuals did not decline, and some actually increased in verbal IQ. Four personality traits (i.e., agreeableness, satisfaction, intellect, extroversion) are stable. The fifth trait, energetic, may reflect responses to external circumstances, including physical health. As for social relationships, most individuals-including the oldest-old-still retain ties with important family members and friends. Individual differences are great, stressing the danger of accepting stereotypes about old individuals.
Caregivers' Perspectives of Placement
Authors: Penrod Janice , Dellasega Cheryl
Published: May 2014

IMPLICATIONS FOR PRACTICE
ENGAGING Black Older Adults and Caregivers in Urban Communities IN HEALTH RESEARCH
Authors: Picot Sandra J Fulton , Tierney June , Mirpourian Nabat , Ericsson Jeneanne M , Wright Jackson T , Powel Lorrie L
Published: May 2014

ABSTRACT

The under- representation of the Black population in research may lead to poor health outcomes for them and a decreased capacity to generalize results to Black populations. This article describes ways in which sensitivity to cultural distinctions of Black older adults and their current or future caregivers can enhance their recruitment and retention in research. Cultural mores play an important role in the shaping of one's perceptions, definitions, responses to disease, and participation in health regimens. Similarly, one's cultural orientation plays a role in how a person is effectively recruited and retained in research. Wenger's translation process model uses cultural meaning to inform research decisions. This model was used in a recent study of Black older adults and their care- c, givers and will be described in this article. Effectively engaging Black individuals in health research is essential for improving their health.
The Complexities of Documenting Clinical Information in Long-term Care Settings in Australia
Authors: Pelletier Dianne , Duffield Christine , Gietzelt Dale , Larkin Patricia , Franks Helen
Published: May 2014

Older adults often have multiple health needs, making charting difficult and time-consuming for nurses. Research on work redesign is suggested to increase nurse productivity and decrease hospital costs.
ELDERLY WOMEN'S Explanation of Depression
Authors: Ugarriza Doris Noel
Published: May 2014

ABSTRACT

Using the Kleinman explanatory mode), 30 elderly women with depression were interviewed about their depression and its treatment. Content analysis was used to classify data into cause, effect, severity, expectations, fears, and treatment. Identified causes were loss of health, family, and role. Depression caused somatizations and a decrease in functional level. Women considered depression to be severe and chose medication as the preferred treatment. Their model of depression differed from that of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) because fatigue and weakness were emphasized more than any other symptoms. Feelings of guilt and worthlessness, weight loss, and suicidal ideation were minimal.
Comprehensive Geriatric Assessment: Exploring Clients' and Caregivers' Perceptions of the Assessment Process and Outcomes
Authors: Aminzadeh Faranak , Amos S , Byszewski A , Dalziel W B
Published: May 2014

This study indicates the importance of linking assessment with care management and follow-up services for the success of out-patient, comprehensive geriatric assessment programs.
Synergism of Frail Rural Elderly Couples: Influencing Interdependent Independence
Authors: Racher Frances E
Published: May 2014

ABSTRACT

In this phenomenological study, a purposive sample of 19 frail rural elderly couples were interviewed as dyads to identify programs, services, and relationships perceived by the couples as beneficial to their ability to continue to live independently in the community. Communication between the partners, and roles and relationships were observed and discussed. Findings showed that mutually supportive dyads generated a synergism or energy that acted as a vital resource to couples. Research results led to the development of a continuum of spousal relationships and a trajectory of couple communication. Support to the couple as a unit, to the couple relationship, and to address the couple's needs may be strategic foci for nurses in their delivery of care and their involvement in planning programs and developing policy.
THE MEANING OF STROKE ELDERLY WOMEN: A Phenomenological Investigation
Authors: Hilton Edith L
Published: May 2014

ABSTRACT

The objective of this article is to discover meanings of stroke in elderly, noninstitutionalized women survivors. Using a qualitative design, a purposive sample of five elderly women in residential settings was studied. Data were gathered through interviews and analyzed using van Manen's method of thematic analysis. An overarching theme of transition with transformation from stroke was identified. Five sub-themes were identified, including deterioration and decline, loss and helplessness, regret, uncertainty and anxiety about the future, and resiliency. Six interwoven additional themes were also identified. Informants experienced numerous changes as a result of stroke that affected ways women perceived themselves and their lives. Knowing meanings of stroke experiences may enable nurses to view stroke survivors with a wider lens, enabling responsive, appropriate care that embraces humanistic perspectives.
Reminiscence Group Activities and Discourse Interaction in Alzheimer's Disease
Authors: Moss Sharon E , Polignano Ellen , White Cynthia L , Minichiello Marcia D , Sunderland Trey
Published: May 2014

ABSTRACT

Reminiscence is an enriching and complex experience having many purposes and functions when used with patients with Alzheimer's disease (AD). Discourse is a component of language that has been shown to decline in patients with AD (Mentis, Briggs-Whittaker, & Gramigna, 1995). This article represents one of the first studies to examine the effects of reminiscence group (RG) activities on discourse interactions in patients with AD. This article specifically addresses the AD population within a RG setting. Observations suggested that objective ratings of conversational discourse would be better (less impaired) in patients with AD when obtained in relatively unstructured environments (e.g., during RG activity) as compared to ratings obtained in conversational environments imposing more structure (e.g., a session in which language function was being evaluated). Comparisons made of conversational and narrative discourse skills observed during different testing environments in patients with AD revealed predicted outcomes. That is, discourse elicited in an environment that was less structured yielded qualitatively better discourse patterns, particularly related to selecting and maintaining a topic, requesting additional information about a topic, changing a topic during conversation, and turn-taking. Results are discussed in terms of their relevance to gerontological nurses managing patients with AD.
Resting and Reactive Blood Pressure
Authors: Frazier Lorraine
Published: May 2014

Predictors of Ambulatory Blood Pressure in Older Adults with Hypertension

Blood pressure management is important in older adults to decrease mortality and morbidity. This study examines methods of measuring and interpreting blood pressure.
The Experience of Hospitalized Elderly Patients
Authors: Huckstadt Alicia A
Published: May 2014

ABSTRACT

Little is known about the subjective experience of older adults during hospitalization. The purpose of this study was to identify and describe the hospitalization process as perceived by older adults. This qualitative study explored hospitalization as perceived by eight White, middle-class, elderly patients in one large, western, acute care hospital. Thirty Initial codes were identified from qualitative interviews, participant observation, and medical records. Using constant comparative analyses, these initial codes were reevaluated and further condensed into seven categories. The categories comprise positive and negative perceptions, including numerous difficulties experienced by these hospitalized older patients. Findings of this study are compared to findings existing in the current literature. These findings may be useful in understanding the problems related to the hospitalization experience, identifying interventions that could minimize stressors, and facilitating this experience for older patients.
Knowledge and Self-efficacy of Community Health Nurses Concerning INTERACTIONS of Prescription Medicines with Over-the-counter Agents and Alcohol
Authors: Neafsey Patricia J , Shellman Juliette
Published: May 2014

ABSTRACT

Knowledge and self-efficacy concerning interactions of prescription medications with over-the-counter (OTC) agents were assessed in community health nurses. Three convenience samples of community nurses were recruited to complete the instruments. The first was a sample of 20 experienced nurses working for a local visiting nurse agency (VNARNs). The second was a sample of 20 bachelor of science in nursing (BSN) students (graduate nurses [GNs]) completing their final nursing rotation with the VNARNs. The third was a sample of 31 nurses enrolled in a graduate program training nurses for advanced practice (APRNs). There were no significant differences in overall mean self-efficacy scores among the groups of community health nurses. The mean scores indicated moderate self-efficacy about prescription-OTC interactions. Post-hoc analyses determined VNARNs had significantly greater knowledge scores than APRNs. Overall mean selfefficacy was not correlated with mean knowledge scores. Inspection of the knowledge item responses revealed nine general misconceptions about OTC medications held by many community nurses in the sample. The data can guide the development of continuing education programs about prescription-OTC interactions aimed at community health nurses.
Using Family-Style Meals to Increase Participation and Communication in Persons with Dementia
Authors: Altus Deborah E , Engelman PhD Kimberly K , Mathews R Mark
Published: May 2014

ABSTRACT

Although researchers stress the importance of encouraging independent behavior in persons with dementia, institutional practices often foster dependence. This study took place in a six-resident locked dementia care unit that followed the common institutional practice of serving meals on prepared plates. The purpose of this study was to examine if changing the mode of meal delivery to "family-style," where residents were presented with serving bowls and empty plates, would increase resident communication and participation in mealtime tasks. An ABAB' reversal design revealed very low rates of appropriate communication (5% of intervals) and mealtime participation (10% of tasks) during baseline, when residents received prepared plates (A). Communication and participation doubled when family-style meal delivery was introduced (B) and dropped back to baseline levels when it was withdrawn (A). Because the levels of communication and participation during family-style meals were still low, the nursing assistant was provided with instruction on prompting and praising appropriate mealtime behaviors (B'). After instruction was provided and family-style meals were reintroduced, resident participation rose to 65% of tasks and appropriate communication increased to 18% of observations. This study suggests familystyle meals may result in modest increases in mealtime participation and communication of residents with dementia, but staff training in prompting and praising may be necessary to see large changes in these behaviors.