bluuebunny/crossref_metadata_2025_split huggingface dataset:
Residents With DEMENTIA in Assisted Living Facilities: The Role of Behavior in Discharge Decisions
Authors: Aud Myra A 
Published: May 2014

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

ABSTRACT
At-home case management is one strategy for improving quality of care for elderly patients with heart failure. Essential components of an effective heart failure case management intervention include frequent patient contact with the case manager and vigilant at-home monitoring of symptoms with responsive modifications to the treatment plan. It is just as important that the health care system (e.g., the acute care institution) is committed to assuring administrative support, financial backing, and dedicating clinical expert resources to achieve clinical quality improvements. In this article, the design, implementation, and outcomes of an at-home heart failure case management program are described, and challenges faced in implementing and sustaining the program are outlined.
INTIMACY NEEDS AND CHRONIC ILLNESS: Strategies for Sexual Counseling and Self-Management
Authors: Steinke Elaine E 
Published: May 2014

ABSTRACT
Individuals experiencing a chronic illness have many needs and concerns. One area frequently overlooked is that of intimacy. Those experiencing cardiovascular illnesses have concerns about the strain of sexual activity on their heart. Individuals with lung diseases may perceive that sexual activity is no longer possible because of breathing difficulties. Accurate information and strategies for self-management are needed to address the intimacy needs and concerns of these individuals. The purpose of this article is to identify intimacy needs and strategies for sexual counseling for individuals with cardiovascular illnesses such as myocardial infarction, heart failure, implantable defibrillators, hypertension, and for chronic lung problems.
GRANDMOTHER CAREGIVER REACTIONS TO Caring for High-Risk Grandchildren "I could write a book!"
Authors: Dowdell Elizabeth Burgess 
Published: May 2014

designed and conducted to examine the relationship between caregiver burden and caregiver physical health for grandmothers raising their high-risk grandchildren. The sample consisted of 104 grandmothers. The findings indicated that caregiver physical health correlated strongly with level of burden and financial status. Further analysis suggests physical health variables had an observable impact on caregiver burden.
Because this study indicates, from descriptive and correlational statistics, that the well-being of the grandmother and grandchild are both linked to the grandmother's physical health, there are numerous nursing interventions that may support a positive outcome for both. The provision of emotional and psychosocial support, coupled with health education and periodic health evaluations, are known to improve a grandmother's perception of her own health. Nurses can use the measures of caregiver burden to develop care plans targeting the health issues most likely to improve a grandmother's functional ability to remain the primary caregiver for a high-risk grandchild.
Community Care GERONTOLOCICAL NURSING: THE INDEPENDENT NURSE'S ROLE
Authors: Caffrey Rosalie A 
Published: May 2014

This article is the second in a series of articles that focus on the independent nurse's role (the first appeared in the April 2005 (Vol. 31, No. 4, pp. 5-11). This series showcases the nurse's diverse responsibilities outside the hospital or long-term care facility. Other articles in this series will appear in upcoming issues of the Journal and will describe to readers the different roles nurses assume in the community.
ABSTRACT
This focused ethnographic study examined the perspectives of seven nurses developing independent practices serving community-based elderly individuals. Six of the nurses' clients, five of whom were foster care providers, were also interviewed. The nursing activities described by these nurses included assessment, documentation, teaching, delegation and assignment, monitoring, advocacy, and support. The services valued by the clients included the nurses' problem-solving approach, advocacy with physicians, and assistance in meeting state licensure requirements. The clients also identified the following benefits: support in providing care to their residents, continuity of care, and personal relationships they developed with the nurses.