bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing Informatics: APPLICATIONS FOR LONG-TERM CARE
Authors: Dyck Mary J
Published: May 2014

ABSTRACT

Long-term care (LTC) settings, specifically nursing homes, have found it difficult to manage the regulatory process and provide quality resident care without computerization. Clinical information systems in the current health care environment, including LTC, need to provide five functions. These five functions are providing the legal record of care; supporting clinical decision-making; capturing costs for financial purposes; accumulating a database for administrative queries, quality assurance, and research; and supporting data exchange between systems. While computerization may have occurred in LTC, the application of the informatics concepts with nursing standardized languages and financial and database usage may not have occurred. To succeed in the current health care environment, nursing informatics concepts need to be implemented in LTC. As a result, the quality of care for older adults in nursing homes will be improved. The purpose of this article is to identify application for nursing informatics use in the LTC setting.
Coping With ANXIETY IN LATER LIFE
Authors: Frazier Leslie D , Waid Lisa D , Fincke Candy
Published: May 2014

The present study explored three forms of anxiety in communitydwelling older adults, the coping strategies used to manage anxious symptoms, and the effect of anxiety on quality of life. Findings show older adults experience moderate levels of distress, anxiety sensitivity, and hypochondriasis. Elevated scores on these anxiety measures were related to greater use of maladaptive coping strategies, such as disengagement and emotional regulation. The implications of these findings for assessment and intervention by gerontological nurses are discussed.
try this: Elder Abuse and Neglect Assessment
Authors: Fulmer Terry
Published: May 2014

Best Practices in Nursing Care to Older Adults

from The Hanford Institute for Geriatric Nursing
Comparison of Family Caregivers: Stroke Survivors VS. Persons with Alzheimer's Disease
Authors: Clark Patricia C , King Kathleen B
Published: May 2014

ABSTRACT

The purpose of this study was to compare family caregivers of person with dementia and caregivers of stroke survivors with similar levels of caregiving responsibilities. The design was descriptive and included characteristics of care recipients, caregivers, and care situations. Caregivers of individuals with dementia reported care recipients were more impaired with independent activities of daily living and memory and behavior problems. There were no differences in caregiver depression and fatigue. Even with the benefit of respite care, a substantial number of caregivers had depression scores above the level indicating possible clinical depression. Consultation by advanced practice psychiatric nurses for caregivers and care recipients may be beneficial in detecting depression and making recommendations for appropriate treatment.
Assault of Long-term Care Personnel
Authors: Levin Pamela F , Hewitt Jeanne Beauchamp , Misner Susan Terry , Reynolds Sheila
Published: May 2014

ABSTRACT

The purpose of this study was to explore contributing factors, consequences, and solutions to assault of long-term care personnel. The study sample consisted of three focus groups composed of certified nursing assistants and administrators employed in long-term care facilities within a large Midwestern city. Using content analysis methodology, multiple themes emerged: worker attitude, vulnerability, work culture, job tasks, training, working short-staffed, financial concerns, changes in social values and health care, community crime, substance abuse, accepting assaults, coworker threats, issues of retaliation, professional withdrawal, and inability to share experiences. Preventive measures suggested by the participants are consistent with those recommended by the Occupational Safety and Health Administration. Implications for staff and administrators include both personal and workplace strategies. Recommendations include implementing more comprehensive violence prevention programs that includes conflict management and training tailored to the type of residents.
Concepts in Health Promotion: PERCEIVED SELF-EFFICACY AND BARRIERS IN OLDER ADULTS
Authors: Easom Leisa R
Published: May 2014

ABSTRACT

Many older adults have reached later life in apparent good health while others' lack of self-care activities has greatly accelerated the process of aging. In this article, self-efficacy and perceived barriers are explored as significant concepts that influence the self-care activities of elderly individuals. A conceptual model is presented depicting perceived self-efficacy and barriers as determinants of self-care activities. This conceptual model differs from earlier health promotion models because it is specific for older adults. Based on empirical studies, this conceptual model demonstrates that the variables of perceived self-efficacy and barriers have a profound effect on an older adult's participation in self-care activities. Testing of this model is needed to provide a knowledge base for designing health promotion strategies, maximizing cost containment strategies, and contributing to Healthy People 2010 objectives of increasing quality of life for all older adults.
A PROGRAM TO Reduce Fatigue in Convalescing Elderly Adults
Authors: Robinson Sherry , Vollmer Charlene , Hermes Brenda
Published: May 2014

ABSTRACT

This study is an examination of the influence of a fatigue reduction program on the level of fatigue experienced by elderly individuals convalescing in subacute units after lower extremity injury, surgery, or weakness. Fifty participants with a mean age of 81 were divided into two groups of 25 participants. The experimental group received a fatigue reduction program consisting of planned rest periods after bathing and therapy; high-protein, high-carbohydrate liquid supplement; and a 3-minute back rub at bedtime. Each participant's level of fatigue was tested soon after admission and 1 week later, and data were analyzed using the paired t test. The difference between the change in pre-test and post-test scores of the two groups was significant in all three measures of fatigue. The experimental group exhibited a significantly greater reduction in fatigue. The outcomes reinforced the value of nursing interventions that have been an integral component of nursing care from its beginning: promoting nutrition, alternating periods of activity and rest, and including a back rub in evening care.
Maintaining Family Connectedness In Long-Term Care: An Advanced Practice Approach to FamilyCentered Nursing Homes
Authors: Logue Rebecca McGarry
Published: May 2014

ABSTRACT

The decision to place a relative in a long-term care institution is one of the most difficult processes families can go through. Family members often experience conflicting feelings of stress, shock, anxiety, fear, resistance, and guilt. In addition, many individuals, regardless of the amount of previous nursing home experiences, possess misconceptions about nursing home care (Grove, 1997; Mastrian & Dellasega, 1996; Tickle & Hull, 1995). Even after the family realizes the necessity of nursing home placement, achieving a level of comfort with such a decision and maintaining family relationships is a difficult challenge. Unfortunately, family-centered nursing care in longterm care settings is hindered by multiple barriers, including resistance to institutional change, family members' fear and hesitation, institutional rules and protocols, lack of institutional encouragement of family involvement, insufficient programs and activities addressing the social and emotional needs of the family, and ineffective communication between the staff and families. To remedy these barriers, it is suggested the family advanced practice nurse (APN) view the families as clients and initiate family-centered policies to encourage family involvement in the caregiving experience. Ultimately, this will promote individualized care of elderly adults and encourage family processes within the walls of the nursing home.
Holding On: Self-Caring with Osteoarthritis
Authors: Baird Carol L
Published: May 2014

ABSTRACT

As women age, they frequently have increasing difficulties with physical functioning associated with osteoarthritis (OA). An understanding of how elderly adults care for their health is necessary to assist older women to live independently. Self-care of five community-dwelling women with OA was investigated through an interpretative descriptive study. A phenomenologic and naturalistic inquiry framework was used. Interviews were conducted using an interview guide. Deconstruction and reconstruction by constant comparison were used for analysis. Participants told stories categorized as Holding On to Present Self, Holding On to Ableness, Holding On to Being Interested and Being Interesting, Holding On By Seeking to Know, and Holding On by Purposefully Choosing and Acting. Older women with OA may have strengths of self-caring, including positive appraisal of their OA and capabilities, maintenance and development of skills, and remaining interested in the world. Health professionals can support clients by assessing strengths and difficulties and helping clients modify activities and to find resources necessary for independent living.
Mealtimes In Nursing Homes: THE ROLE OF NURSING STAFF
Authors: Pearson Alan , Fitzgerald Mary , Nay Rhonda
Published: May 2014

ABSTRACT

The literature suggests that food service largely has become identified as a non-nursing duty and as a task that should be completed as quickly as possible. This conflicts with the evidence that social interaction at mealtimes has the potential to promote well being. Using observational and interview techniques, the social and functional context of meal service in 10 nursing homes was examined in this study. The findings from the observation of and interviews with staff are reported in this article. Three broad themes describing the cultural practices of nursing home staff during mealtimes are identified as follows: maintaining personal identity, assisting individuals to eat, and maintaining interaction. Alongside residents' general outward acquiescence to the service, nurses did not see problems and deficiencies with the service observed by the researchers or reported by the residents. Recommendations to improve mealtime service in nursing homes have been put forward in an effort to enlighten staff.
Older Ethnic Women in Faith Communities
Authors: Hahn Karen
Published: May 2014

Culturally Appropriate Program Planning Nurses can implement strategies to reduce the disparity of health status in minority groups as compared to the total U.S. population.
Analysis of the Concept of Aloneness: AS APPLIED TO OLDER WOMEN BEING TREATED FOR DEPRESSION
Authors: Pierce Linda L , Wilkinson Laura K , Anderson Judith
Published: May 2014

ABSTRACT

The concept of aloneness is examined in very few published materials. This article analyzes the concept of aloneness through the experiences of eight older women being treated for depression. When the women were depressed, they viewed aloneness as being vulnerable, fearful, helpless, and as having a loss of control of self and identity confusion. As the women progressed in their recovery from depression, they viewed aloneness as being self-reliant, hopeful, and resourceful and as having self-determination and self-reflection. Establishing and clarifying the meaning of aloneness for older women during their depression and during their recovery from depression is basic to using the concept of aloneness in nursing theory development and in gerontological nursing practice, education, and research.
Health Characteristics of Elderly Residents in Personal Care Homes: Dementia, Possible Early Dementia, And No Dementia
Authors: Quinn Mary Ellen , Johnson Mary Ann , Andress Elizabeth L , McGinnis Pat
Published: May 2014

ABSTRACT

Personal care homes are becoming an integral part of the gerontological health care environment. This exploratory descriptive study compares the health characteristics of elderly personal care home residents without dementia or cognitive impairment, residents with possible early dementia, and residents with dementia. Results indicate a number of residents with possible early dementia, but without a diagnosis of dementia, may be residing in personal care homes. Additionally, the three groups may have distinctly different service needs. Residents with dementia were particularly at risk for problems with decision-making, communication, and impaired instrumental activities of daily living (IADL). Medication management for residents with dementia emerged as a particular concern. Most physical health characteristics, such as health care usage, were not significantly different in the three groups. Suggestions for strategies to promote the health and well-being of this growing population are discussed.
Institutionalization in Taiwan
Authors: Kao Hsueh-Fen Sabrina
Published: May 2014

The Role of Caregiver Gender

Cultural differences between Western and Eastern societies are reflected in caregiving responsibilities and the decision to institutionalize elderly family members.
Family and Staff Partnerships in Long-Term Care: A Review of the Literature
Authors: Bauer Michael , Nay Rhonda
Published: May 2014

ABSTRACT

Working with the family in aged care to provide the best care possible is consistent g with modern nursing philosophy, which espouses holistic care. The quality and enjoyment of the experience, however, is frequently fraught with problems and challenges for both the family and the staff involved. In residential aged care, ? partnerships are a complex I mix of interactions among the older adult resident, the family, and the caregiving staff. To understand how · family involvement in this I environment can be made I more meaningful, nurses I eed to be cognizant of how amily members experience ie caregiving role and how iey are perceived by ursing home staff and 'esidents. The relevant terature of the past 20 ears is reviewed and key isues central to an mderstanding of "family :are" in the nursing home rom the perspective of the amily, the nursing home esident, and the nursing I iome staff are highlighted in his article.
Creating a Therapeutic Psychosocial Environment in Dementia Care: A Preliminary Framework
Authors: Werezak Leona J , Morgan Debra G
Published: May 2014

ABSTRACT

Research in dementia care during the past few years has focused on identifying and designing therapeutic physical environments while the psychosocial environment has remained a largely unexplored domain. More recently, discussions regarding the effect of the social environment on individuals with dementia have increased in the literature. Nevertheless, the authors suggest the term "social environment" does not adequately represent the critical psychological and emotional effect social interaction has on individuals with cognitive impairment. Through an examination of the literature, three conceptual frameworks, and clinical observations of several special care units (SCUs), the authors suggest that the psychosocial environment is the most important element of institutional dementia care. A preliminary conceptualization is offered which identifies the elements necessary to facilitate a supportive psychosocial environment in long-term care. The potential benefits of implementing such a model include preservation of personhood, simple recognition of remaining abilities and a decreased focus on disabilities, and reduction of pharmacologie therapy for disruptive behavior resulting in overall improvement in quality of life.
Older Adults with Osteoarthritis: Psychological Status and Physical Function
Authors: Kee Carolyn C
Published: May 2014

ABSTRACT

The purpose of this study was to identify how sododemographic characteristics such as age, race, and socioeconomic status; psychosocial factors of hardiness, health promotion practices, and social support; health status; and pain are related to the ability of older, community-residing individuals with osteoarthritis (OA) to maintain psychological equilibrium and physical function. A total of 81 older adufe with OA completed a survey that induded a sododemographic data form, a hardiness scale, a measure of health promoting practices, and five subscales from the Arthritis Impact Measure Scale 2 on social support, general health status, pain, and psychological status and physical function. Analyses using multiple regression showed that hardiness, pain, and social support were significant contributors to psychological status and physical function and, respectively, accounted for 53% and 54% of the variance. By knowing about OA and being aware of factors that contribute to maintaining independence in individuals with OA, nurses can provide expert help to aging individuals.
Anxiety and Nighttime Behavioral Disturbances: Awakenings in Patients with Alzheimer's Disease
Authors: McCurry Susan M , Gibbons Laura E , Logsdon Rebecca G , Teri Linda
Published: May 2014

ABSTRACT

This study was conducted to describe the relationship between anxiety and nighttime behavioral disturbance in a community-dwelling sample of patients with Alzheimer's disease (AD). Data from 153 patients with probable or possible AD and their family caregivers were analyzed using logistic regression modeling. Ratings of nighttime behavioral disturbance were based on caregiver reports of how often patients had awakened them at night during the past week. Standardized ratings for patient cognitive, functional, and behavioral status, and for caregiver sleep, depression, and burden were collected. Fifty-six percent of the patients with AD showed symptoms of anxiety, and 29% had awakened their caregiver at least once at night during the past week. Patient awakening was associated with higher levels of patient anxiety (odds ratio [OR] = 2.1; confidence Interval [Cl] = 1.4, 2.9) and patient impairments in activities of daily living (OR = 1.6, Cl = 1.2, 2.3). No other demographic, cognitive, functional, or behavioral variables were significant, including depression. In un i varíate analyses, individual patient anxiety symptoms (e.g., feeling anxious; showing physical signs of anxiety, agitation, and irritability) were significant risk factors for patient awakenings. Of these, showing physical signs of anxiety remained a significant risk factor in multivariate analyses. Results suggest that anxiety and nighttime awakening are highly interrelated in patients with moderate dementia due to AD1 and treatments targeting both may be more efficacious than those focusing on anxiety or sleep alone. They also reveal the importance of assessing anxiety as well as depression in the research and clinical care of patients with AD.
Physical Restraint Use in Health Care Settings: Public Attitudes in Israel
Authors: Hendel Tova , Fradkin Malka , Kidron Dalia
Published: May 2014

By understanding consumers' attitudes, nurses can work to change procedure and reduce restraint use.
Compiling Life History Resources for Older Adults in Institutions: Development of a Guide
Authors: Reichman Sonia , Leonard Carol , Mintz Tessa , Kaizer Cindy , Lisner-Kerbel Heather
Published: May 2014

ABSTRACT

Focus groups were conducted for nursing staff, visiting family members, and residents of a long-term care facility, with the purpose of developing a guide for compiling a life history resource. When compiling the proposed guideline, one must consider not only the topics to include, but also the process of collecting the information and the format for presentation. A key finding was that members of all three groups believed that the process of sharing and collecting life history information was an important step in promoting and enhancing the relationship between nursing staff and residents, and nursing staff and residents' families.
Multisensory Environments for Leisure: Promoting Well-being in Nursing Home Residents With Dementia
Authors: Cox Helen , Burns Ian , Savage Sally
Published: May 2014

ABSTRACT

Multisensory environments such as Snoezelen® rooms are becoming increasingly popular in health care facilities for older individuals. There is limited reliable evidence of the benefits of such innovations, and the effect they have on residents, caregivers, and visitors in these facilities. This two-stage project examined how effective two types of multisensory environments were in improving the well-being of older individuals with dementia. The two multisensory environments were a Snoezelen room and a landscaped garden. These environments were compared to the experience of the normal living environment. The observed response of 24 residents with dementia in a nursing home was measured during time spent in the Snoezelen room, in the garden, and in the living room. In the second part of the project, face-to-face interviews were conducted with six caregivers and six visitors to obtain their responses to the multisensory environments. These interviews identified the components of the environments most used and enjoyed by residents and the ways in which they could be improved to maximize well-being.
Preventive Health Practices: Comparison of Family Caregivers 50 and Older
Authors: Matthews Judith Tabolt , Dunbar-Jacob Jacqueline , Sereika Susan , Schulz Richard , McDowell B Joan
Published: May 2014

ABSTRACT

The purpose of this study was to describe adherence to recommended preventive health practices among middle-aged and older male and female family caregivers of individuals receiving home health services. Perceptions of the burden and benefit of caregiving, wellness orientation, social participation, and community resource use by the caregiving dyad (caregiver and carereceiver) were also explored using the t test and the χ
p 2
test to detect gender differences. A sample of 319 participants 50 and older was recruited from a home health agency in southwestern Pennsylvania to participate in a telephone survey. Results revealed that caregivers had performed 86% of ageand gender-appropriate preventive health practices, but they currently adhered to guidelines for 63% of such behaviors, regardless of gender. Men experienced less burden than women, and were more likely to acknowledge that caregiving made them feel useful and appreciated and gave more meaning to their lives. The study suggests that family caregivers may be as vigilant in their preventive health behavior as the general population, despite their responsibilities. Nurses in contact with middle-aged and older family caregivers are well positioned to encourage health promotion and disease prevention behaviors in this accessible population.
Education, Empowerment, and Elderly Adults: Enhancing Nursing Expertise in the Long-Term Care Setting
Authors: LeCount Jill
Published: May 2014

A formal geriatric nursing educational program helps nurses improve their skills and generates interest in this gowing field.
Gerontology Coursework in Undergraduate Nursing Programs in the United States: A Regional Study
Authors: Grocki Julie H , "Bert" Fox Glenn E
Published: May 2014

ABSTRACT

Because of the changing demographics, it is increasingly necessary for nurses to acquire competence in gerontology. In this article, the authors present the findings of a study investigating the extent to which undergraduate nursing programs in the United States include gerontology. Fifty-six undergraduate nursing programs in the United States were examined. In this study, course content and program curricula were examined to assess the extent to which programs include gerontological content, either integrated into other courses, or as required, stand-alone courses. The sample was randomly chosen from the Northeast, South, West and Midwest regions. All programs were accredited. More than 85% of programs evaluated did not require coursework in gerontology. The authors suggest that nurses are not being educated adequately to care for older adults.
Depression and Social Support: Effective Treatments for Homebound Elderly Adults
Authors: Loughlin Agnes
Published: May 2014

Detecting, assessing, and properly treating depression in homebound older adults can be tricky. Social support alone may not be the answer.
EFFECTS OF Urinary Incontinence: Psychological Well-Being and Distress in Older Community-Dwelling Women
Authors: Heidrich Susan M , Wells Thelma J
Published: May 2014

ABSTRACT

Urinary incontinence (Ul) has been related to lower quality of life. However, the research has generally been cross- sectional, and causal relationships have not been determined. This research was a secondary analysis of a 6-year longitudinal study of chronic illness and psychological well-being in older (mean age = 73 at Time 1), community-dwelling women (n = 103). Over time, women with Ul reported significantly lower subjective health, purpose in life, affect balance, personal growth, positive relations with others, and self-esteem and higher scores for depression, compared to women without Ul. Incontinence had broad effects on multiple domains of psychological wellbeing that persisted over time and need to be addressed by clinicians.
PROMOTING SAFER HOME ENVIRONMENTS for Persons With Alzheimer's Disease: The Home Safety/Injury Model
Authors: Hurley Ann C , Gauthier Mary Anne , Horvath Kathy J , Harvey Rose , Smith Sally J , Trudeau Scott , Cipolloni P B , Hendricks Ann , Duffy Mary
Published: May 2014

ABSTRACT

This article describes a Home Safety/Injury Model derived from Social Cognitive Theory. The model's three components are safety platform, the person with dementia, and risky behaviors. The person with dementia is in the center, located on the safety platform composed of the physical environment and caregiver competence. The interaction between the underlying dementia and indicators of frailty can lead to the person with dementia performing risky behaviors that can overcome the safety platform's resources and lead to an accident or injury, and result in negative consequences. Through education and research, the model guides proactive actions to prevent risky behaviors of individuals with dementia by promoting safer home environments and increased caregiver competence.
New Technology for Medication Adherence: Electronically Managed Medication Dispensing System
Authors: Buckwalter Kathleen Coen , Wakefield Bonnie J , Hanna Barbara , Lehmann Julie
Published: May 2014

Increasing medication compliance can improve quality of life for older adults.
Elder Care Supportive Interventions Protocol: Reducing Discomfort in Confused, Hospitalized Older Adults
Authors: Miller Judy , Campbell Jane , Moore Katherine , Schofield Anna
Published: May 2014

ABSTRACT

This study tested the Elder Care Supportive Interventions Protocol (ECSIP), which are nursing and family support interventions designed to reduce discomfort and the associated consequences of delirium, impaired physical function, and need for post-hospital care in hospitalized older adults experiencing confusion from delirium or dementia. All adults older than age 74 or older than age 64 if from a nursing home who were admitted to the medical and surgical units of a tertiary care hospital were screened for a diagnosis of dementia, dependence on functional activities, or delirium. The ECSIP includes interventions to prevent and control discomfort, and to promote environmental organization and familiarity. Outcome measures administered within 48 to 72 hours of admission and again within 24 hours prior to discharge included the modified Discomfort Screen - Dementia Alzheimer's Type, NEECHAM Confusion Scale, and Katz Index of Activities of Daily Living. Patients problems with delirium and impaired physical function improved over hospitalization but were still pronounced at discharge. With the exception of reduced discomfort, there were no significant treatment effects for patients, which is attributed, in part, to inadequate implementation of the ECSIP protocol by nursing staff.
Assaultive Behavior in Alzheimer's Disease: IDENTIFYING IMMEDIATE ANTECEDENTS DURING BATHING
Authors: Somboontanont Wilaipun , Sloane Philip D , Floyd Frank J , Holditch-Davis Diane , Hogue Carol C , Mitchell C Madeline
Published: May 2014

ABSTRACT

To identify immediate antecedents of bathing-related physical assaults against caregivers by nursing home residents with Alzheimer's disease and related disorders, videotapes of nursing home residents who physically assaulted nursing assistants during baths were analyzed. Caregiver behaviors that occurred significantly (p < .01) more often during the 5 seconds preceding an assault included: calling the resident by name, confrontational communication, invalidation of the resident's feelings, failure to prepare the resident for a task, disrespectful speech, any touch, absence of physical restraint, and hurried pace of bath. Assaults were significantly more likely when caregivers sprayed water without a verbal prompt; the resident's feet, axilla, or perineum were touched; residents exhibited signs of temperature discomfort; and multiple caregivers were present. Improved caregiver training and individualized, gentler bathing methods should be investigated as methods of reducing assaults.
Older Adults and THE ARTS: The Importance of Aesthetic Forms of Expression in Later Life
Authors: Wikström Britt-Maj
Published: May 2014

ABSTRACT

The purpose of this study was to examine the importance of aesthetic forms of expression in a randomly selected Swedish population age 65 to 89. Data were based on semi-structured interviews with 166 participants. Results revealed dance, music, literature, and pictures were important for this group of elderly individuals in promoting successful aging, and the connection to their everyday life was apparent. Participants considered viewing natural scenes and looking in a photo album as important aesthetic activities. The aesthetic forms of expression contributed to physical and intellectual activities, as well as to interaction with other individuals. Aesthetic experiences were related to feelings of timelessness and spacelessness, and served as sources of gratification.
UNRECOGNIZED Chronic Dehydration in Older Adults: Examining Prevalence Rate and Risk Factors
Authors: Bennett Jill A , Thomas Valorie , Riegel Barbara
Published: May 2014

ABSTRACT

Dehydration has serious consequences for older adults, including increased risk of illness or death. This retrospective review of medical records describes the prevalence, assessment, and risk factors for chronic dehydration in 185 older adults who visited an emergency department in June 2000. Results showed chronic dehydration was present in 89 (48%) patients. Physicians documented assessment for signs of dehydration in 23 (26%) of the dehydrated older adults, but no independent assessments for dehydration were recorded by nurses. These findings indicate many older adults may suffer from unrecognized dehydration, and nurses should be alert to the possibility that dehydration may be present in community-dwelling older adults as well as those who live in residential facilities.
OLDER ADULTS AND Autonomy in Acute Care: Increasing Patients' Independence and Control During Hospitalization
Authors: Jacelon Cynthia S
Published: May 2014

ABSTRACT

In a grounded theory study of the experience and actions of hospitalized older adults, autonomy emerged as a major focus, particularly during the last phase of hospitalization. Autonomy, defined in the derived theory as older adults' freedom and ability to act on their own behalf, has two components: independence (the physical ability to act) and control (the ability to make decisions on one's own behalf). Being in the hospital threatens the autonomy of older adults. This article describes changes in the autonomy of older adults throughout hospitalization and makes recommendations for improving their autonomy through acute care hospital system redesign.
Expectations for Care: Older Adults' Satisfaction With and Trust in Health Care Providers
Authors: Hupcey Judith E , Clark Mary Beth , Hutcheson Cristina R , Thompson Virginia L
Published: May 2014

ABSTRACT

This study sought to determine whether community-dwelling older adults' expectations for care were met by identifying factors that influence trust in and satisfaction with health care providers. Data were collected using a demographic questionnaire and focus group methodology. A total of 39 older adults participated in 8 focus groups. Three categories of themes were identified: a sense of personal touch, technical proficiency, and environmental factors. These categories related to individual providers or practice environments. When providers and practice settings met expectations for care, then the elderly individual was satisfied. Trust was more complex, as the older adults indicated they could be satisfied but not trust providers or they could trust providers but not be satisfied. Implications for practice include spending quality time with older adults and treating them as individuals.
Management of Tobacco Dependence in Older Adults: Using Evidence-Based Strategies
Authors: Andrews Jeannette O , Heath Janie , Graham-Garcia Judy
Published: May 2014

Evidence-based behavioral and pharmacological approaches to smoking cessation interventions can be used by gerontological nurses to assist older adults in "kicking the habit "
EVERYDAY ETHICS in Assisted Living Facilities: A Framework for Assessing Resident-Focused Issues
Authors: Powers Bethel Ann
Published: May 2014

ABSTRACT

This article describes and illustrates a framework that may be used when assessing the moral basis of everyday issues that can affect residents of assisted living facilities. The "taxonomy of everyday ethical issues" was an outcome of ethnographic research focused on care of nursing home residents with dementia. However, in this article it is shown to be equally relevant for conceptualizing issues affecting cognitively intact as well as cognitively impaired residents across these two settings. The taxonomy is grounded in some of the more common cultural characteristics of congregate living arrangements for elderly individuals who have needs for varying levels of compensatory and therapeutic oversight by a staff of service providers.
Nurse Staffing in Nursing Homes in the United States: Part I
Authors: Harrington Charlene
Published: May 2014

ABSTRACT

This study described the nurse staffing standards in nursing homes in all states and the District of Columbia in 2000 to 2001. An Internet survey of state statutes and regulations and a structured telephone survey of state officials were used to collect data for this descriptive study. Almost half of the states had higher licensed nurse (registered nurse and licensed vocational nurse) requirements than the federal government and 33 states had established minimum state requirements for direct care workers (including nursing assistants). Thirteen states had increased their state standards i n the 1999 to 2001 period. Federal standards for nursing homes lag behind those in many states.
THE CONTEXT for Nursing Home Resident Care: THE ROLE OF LEADERS IN DEVELOPING STRATEGIES
Authors: Swagerty Daniel L , Lee Robert H , Smith Barbara , Taunton Roma Lee
Published: May 2014

ABSTRACT

Data obtained from three Midwestern nursing homes were used to identify and describe contextual factors that influenced resident care. A qualitative, emergent, case study design guided the study. In addition to 17 residents and 16 family members or friends of the respective residents, participants included 66 staff members and 9 managers involved in the planning and delivery of care to the participating residents. Data were collected via observation, semi-structured interview, and resident record audit. Contextual factors seemed to integrate or fragment care planning and delivery. Important integrators were shared values, the role of the Minimum Data Set coordinator, the role of other leaders, and family influence. Two fragmenting factors, competing demands for the staff members' time and a task orientation to care, appeared to be ubiquitous. External accountability also fragmented care to a discernible degree.
A TRAINING PROGRAM FOR Managing Agitation of Residents in Long-Term Care Facilities: DESCRIPTION AND PRELIMINARY FINDINGS
Authors: Landreville Philippe , Dicaire Louise , Verreault René , Lévesque Louise
Published: May 2014

ABSTRACT

The purpose of this article is to describe a training program for managing agitation of long-term care residents and to report results of a pilot study. The program emphasizes the development of behavioral skills for the assessment, prevention, and reduction of both aggressive and non-aggressive agitated behavior. It includes 8 hours of class instruction followed by 8 hours of weekly supervision by the trainers. The nursing staff of all working shifts of a unit located in a large nursing home and the residents of this unit participated in the pilot study. Residents and staff were assessed prior to and after the 2-month training program. Staff members reported using behavioral techniques to a greater extent and feeling more effective in managing agitation after training. More than 90% of staff members were satisfied with the training program. During the supervision period, the staff developed and implemented individualized interventions for two residents. The interventions involved providing more attention to these residents and, in one case, modifying some aspects of the direct environment which seemed to trigger agitation. Both residents were less agitated after the interventions were implemented. Moreover, there was a reduction in the number and frequency of agitated behaviors for the other residents of the trainees' unit following staff training.
SELF-MANAGEMENT OF ALCOHOL PROBLEMS Among Aging Adults
Authors: Finfgeld-Connett Deborah L
Published: May 2014

ABSTRACT

Alcohol abuse among aging adults is thought to be one of the fastest growing health concerns in the United States. To manage this problem, a stepped-care approach is recommended. This approach consists of brief interventions and, if necessary, a more extensive treatment program to help individuals self-manage their drinking habits. Brief interventions fall within the harm reduction philosophy and normally consist of one to five short sessions. In contrast, The Gerontology Alcohol Project (GAP) offers a more comprehensive treatment protocol for individuals who require enhanced self-management guidelines. Both treatment strategies are supported by research conducted with older alcohol abusers.
Care Intervention for Older Adults with Alzheimer's Disease and Related Dementias: Effect of Family Involvement on Cognitive and Functional Outcomes in Nursing Homes
Authors: Jablonski Rita A , Reed David , Maas Meridean L
Published: May 2014

ABSTRACT

The purpose of this quasi-experimental study was to examine the effect of an intervention for caregivers of individuals with Alzheimer's disease and related dementias (ADRD) on nursing home residents' functional and cognitive status. Fourteen special care units (SCUs) in 14 midwestern nursing homes were paired according to size, ownership, and staff turnover. The paired nursing homes were randomly assigned to either experimental or control groups. The intervention consisted of the Family Involvement in Care (FIC) protocol. The FIC intervention was designed to help family caregivers of nursing home residents with dementia negotiate and establish a partnership with the staff caregivers for the care of residents. One hundred sixty-four residents participated in the study, 71 in the control group and 93 in the experimental group. Sixty-three residents were lost to attrition (38%).

The experimental group exhibited less global deterioration throughout the study. Inappropriate behavior, cognition, and functional status remained relatively unchanged over time within and between the groups, Increased family involvement did slow global deterioration in individuals with ADRD. The findings of the study show that more factors need to be examined to discover those interventions that preserve functional and cognitive abilities.
Feeding Beliefs of Certified Nurse Assistants in the Nursing Home: A Factor Influencing Practice
Authors: Pelletier Cathy A
Published: May 2014

CNAs are often responsible for feeding nursing home residents. It is important their training include all factors that can influence feeding practices.
The Oral Health of Older Adults: An Interdisciplinary Mandate
Authors: Bailey Regan , Gueldner Sarah , Ledikwe Jenny , Smiciklas-Wright Helen
Published: May 2014

Interventions using a comprehensive, community-based approach are necessary to correct the oral health deficits in this vulnerable population.
THE EVOLUTION OF Hospice in America: Nursing's Role in the Movement
Authors: Hoffmann Rosemary L
Published: May 2014

ABSTRACT

In the current society, many individuals fear death and the feelings of suffering and loneliness that often accompany death. Two visionaries in the United States, Florence WaId and Dr. Elisabeth Kubler-Ross, recognized these fears and planned the nation's first hospice movement in the 1970s. The hospice philosophy continues to prosper in the new millennium. In this article, the founding American hospice's philosophy, types of facilities, standards, health team composition, patient demographics, organizations, reimbursement, and research are compared and contrasted with those of the current hospice movement. Existing issues with the modern movement are also discussed.
Palliative Care NURSING EDUCATION: OPPORTUNITIES FOR GERONTOLOGICAL NURSES
Authors: Ersek Mary , Ferrell Betty R
Published: May 2014

ABSTRACT

Approximately 80% of Americans who die each year are 65 or older. Increasingly, gerontologi cal nurses are asked to deliver high quality end-of-life care. Studies, however, have identified deficiencies in the delivery of care to older adults who are dying-particularly those who die in nursing homes. Enhancing nursing education and training in end-of-life care is one strategy proposed as a remedy for inadequate care for nursing home residents who are dying. This article reviews the current status of end-of-life nursing home care, describes the philosophy and components of quality palliative care, and provides information about opportunities and resources for educating gerontological nurses in end-of-life care.
Empowerment Through Relationships
Authors: Popejoy Lori
Published: May 2014

Giving Patients a Voice
Building Relationships in Residential Long-Term Care
Authors: Gaugler Joseph E , Ewen Heidi H
Published: May 2014

Determinants of Staff Attitudes Toward Family Members

ABSTRACT

The objective of this study was to identify staff-, family-, facility-, and resident-level predictors of staff attitudes toward family members. Data were used from 41 care staff members recruited from 5 nursing homes, 5 assisted living facilities, and 16 family care homes. A multiple regression model found that staff who reported greater quality in their relationships with residents also tended to indicate more positive perceptions of family members. The findings emphasize the need to consider family, resident, and staff relationships in concert when designing and implementing nursing interventions to improve quality of life and care in residential settings.
Spiritual Caring: End of Life in a Nursing Home
Authors: Touhy Theris A , Brown Cynthia , Smith Carol J
Published: May 2014

ABSTRACT

The purpose of this qualitative study was to explore spiritual care for dying nursing home residents from the perspectives of registered nurses, practical nurses, certified nursing assistants, advanced practice nurses, and physicians. Five major themes emerged: honoring the person's dignity, intimate knowing in the nursing home environment, wishing we could do more, personal knowing of self as caregiver, and struggling with end-of-life treatment decisions. Spiritual caring was described within the context of deep personal relationships, holistic care, and support for residents. Spiritual care responses and similarities and differences in the experiences of participants are presented. Education and research about how to assist residents and families as they struggle with difficult end-of-life decisions, adequate time and staff to provide the kind of care they "wished they could," and development of models that honor the close connection and attachment of staff to residents could enhance end-of-life care in this setting.
Visual Spatial Abilities and Fall Risk
Authors: Olsson Roy H , Wambold Suzanne , Brock Barbara , Waugh Diana , Sprague Heather
Published: May 2014

An Assessment Tool for Individuals with Dementia

ABSTRACT

Risk of falling is a major concern of long-term care facilities with residents diagnosed with dementia. Use of a brief cognitive assessment focusing on visual spatial abilities could be one strategy in the prevention of falls in residents with dementia. The objective of this study was to determine if a clock test could predict a risk of falls in residents diagnosed with dementia. Three hundred sixtyfour individuals with dementia participated (92 men and 272 women; ages 37 to 100, mean 80.5 years, median 83 years). Each participant was given the Reality Comprehension Clock Test (RCCT) three times, and Mini Mental-Status Examination (MMSE) two times to determine criterion-related validity, test-retest reliability, internal consistency; and to set and evaluate a risk of falls score based on the Visual Spatial Score (VSS) component produced by the RCCT Significant findings included .72 (p < .01) correlation between the RCCT and the MMSE, .90 (p < .01) correlation between the first administration of the RCCT and the second administration of the RCCT; an alpha of .95 (p < .001) and an F value of 76 (p < .001) producing a risk of falls initial VSS of 5 or lower compared to 9 or greater. Ch i -square of 6.3 for 30 days (p < .01), 11.08 for 60 days (p < .01) and 13.3 for 90 days (p < .01) indicated a significant difference in the number of falls occurring in the high risk group (VSS of 5 or lower) compared to the low/ no risk group (VSS of 9 or higher). A risk factor analysis suggested that residents in the higher risk group were three times more likely to have fallen than residents in the low risk group. Knowing a resident's visual spatial ability offers health care providers an opportunity to implement a resident-specific intervention that addresses their cognitive ability and visual spatial deficit that may reduce the resident's risk of falling.
Creating a Multisensory Environment for Dementia
Authors: Ball Julia , Haight Barbara K
Published: May 2014

The Goals of a Snoezelen® Room
Quality Improvement in Nursing Facilities: A NURSING LEADERSHIP PERSPECTIVE
Authors: Adams-Wendling Linda , Lee Robert
Published: May 2014

ABSTRACT

The purposes of this study were to characterize the state of quality improvement (Ql) in nursing facilities and to identify barriers to improvement from nursing leaders' perspectives. The study employed a non-experimental descriptive design, using closedand open-ended survey questions in a sample of 51 nursing facilities in a midwestern state. Only two of these facilities had active Ql programs. Furthermore, turnover and limited training among these nursing leaders represented major barriers to rapid implementation of such programs. This study is consistent with earlier findings that Ql programs are limited in nursing homes.
On-line Communities: Helping "Senior Surfers" Find Health Information on the Web
Authors: Moore Georgia A
Published: May 2014

ABSTRACT

Currently, it is estimated that approximately 10 million older adults use Internet communities to gain information on any health issue. It is nearly impossible to police all of the sites available to make sure correct information is distributed. A short website review demonstrates factors that create an unsafe or safe health environment. The ability of a facilitator to properly manage an online community and the problems that may be encountered in this setting are issues that warrant attention. Discussion forums provide information through threaded discussion boards, and frequently the information is inaccurate. Research is needed to determine if on-line health communities are a bane or a boon to the elderly population.