bluuebunny/crossref_metadata_2025_split huggingface dataset:
DISCHARGE PLANNING FOR Elderly Patients
Authors: Rosswurm Mary Ann , Lanham Debra M 
Published: May 2014

ABSTRACT
The complex chronic health problems and functional limitations common in the elderly population place them at risk for complicated hospitalizations and discharge planning. The purpose of this study was to investigate the effectiveness of a discharge planning protocol in identifying elderly patients' home care needs. The sample in this quasiexperimental study consisted of 507 hospitalized patients age 65 years or older. The control group received the usual hospital discharge planning protocol. In the experimental group, nurse/social worker teams coordinated the discharge planning process, using an adapted form of the Discharge Planning Questionnaire (DPQ) to identify the home care needs of elderly patients. Thirty days after hospital discharge, both patient groups participated in a telephone survey to obtain information about health care problems they experienced during home recovery and their use of health care resources.
The findings indicated that the majority of the elderly patients had functional dependencies, which required the help of another person to carry out daily household duties and provide assistance with basic needs, especially ambulation. These functionally dependent patients only received home care referrals about 50% of the time. These findings raise questions about current reimbursable services. Logistic regression analysis indicated that patients with increased functional dependency and patient problems during home recovery had a greater likelihood of rehospitalization and emergency department usage. This information about the home care of elderly patients after hospitalization supports the need for comprehensive functional assessment as part of discharge planning. This study also suggests that the nurse/social worker team can provide effective screening and discharge planning coordination of home care. Physician involvement and effective communication networks must be in place.
Testing the Uniform Needs Assessment Instrument for Hospital Discharge Planning With Older Adults
Authors: Westra Bonnie L , Holland Diane E , Aufenthie Judy , Cullen Laura , Finley Janet , Griebenow Linda , Hess Gale , Jacobson Theresa , Kennebek Sue , McHale Janyce , McMyler Eileen , Ohland Jill , Ryan Sheila , Wollan Peter 
Published: May 2014

ABSTRACT
The Uniform Needs Assessment Instrument (UNAI) was developed to systematically assess the continuing care needs of high-risk older adults in response to the 1986 Omnibus Budget Reconciliation Act. Based on previous studies, a revised UNAI was tested with 103 hospitalized older adults, comparing usual discharge planning with the UNAI. High interrater reliability was obtained. The UNAI had high (≥ 85%) sensitivity and specificity when comparing needs identification on the UNAI with subjects' reported needs at 10 to 14 days after discharge. Overall, the UNAI was more effective (sensitive and specific).
GERONTOLOGICAL NURSING IN THE 21ST CENTURY
Authors: Burggraf Virginia , Barry Richard 
Published: May 2014

ABSTRACT
The approaching millennium brings not only a muted but also a challenging vision for the future of gerontological nursing. This vision is muted by the rhetoric of the 90s dictating the elimination of costly programs with the potential to diminish quality. It is a vision of challenge to advocate for, protect, demand, and create a new framework that will guarantee high-quality health care for older patients.
In an attempt to clarify that vision, this article outlines three areas of gerontological nursing: education, practice, and research. The future direction in these areas will dictate how collective thinking can support health care for older people in the next century and beyond. These components of nursing must be integrated to develop quality care needed by older patients.
BALANCE AND MUSCLE STRENGTH as Predictors of Frailty Among Older Adults
Authors: Dayhoff Nancy E , Suhrheinrich Joy , Wigglesworth Janet , Topp Robert , Moore Susan 
Published: May 2014

ABSTRACT
The term frailty is increasingly used in gerontological literature and in practice. However, indicators differentiating frail from nonfrail are not well delineated. Identifying factors discriminating between frail and nonfrail older community-residing adults may lead to more comprehensive clinical assessments and targeted interventions to minimize or prevent frailty. Eighty-four adults, ages 60 to 88 (mean = 74) living independently in the community completed a functional performance questionnaire and a perceived health questionnaire that were combined as measures of frailty. Predictor variables of frailty included four measures of balance and three measures of lower leg strength. Discriminant analysis revealed that one balance score and dorsiflexion correctly classified 65% of group membership, with better prediction of the nonfrail than frail group. This study clarifies that the predictors of frailty include the combination of dorsiflexion strength and balance, specifically the contribution of vision to balance when the support surface is compliant. Recommendations are proposed for conceptualizing and operationalizing frailty and adding variables to enhance discrimination between frailty and nonfrailty. Nursing implications include adding clinical assessments of specific components of balance and ankle strength to develop a more comprehensive evaluation of frailty.
A Procedure for WITHDRAWAL OF SLEEP MEDICATION in Elderly Women Who Have Been Long-Term Users
Authors: Tabloski Patricia A , Cooke Kristin M , Thoman Evelyn B 
Published: May 2014

ABSTRACT
A program for withdrawal of sedative/hypnotic medication was investigated in elderly women, ages 64 to 91. The sleep cycles of 10 drug withdrawal (DVV) and 10 non-drug withdrawal (N-DW) subjects were monitored for a 24-hour period for 5 successive weeks, using a nonintrusive recording procedure. The first 2 baseline weeks were followed by 1 week of half-dose, then 2 weeks of full withdrawal for the DW group. The results indicated no demonstrable effect on sleep, sleep complaints, levels of depression, or daytime sleepiness on the DW group. The conclusion is that the procedure of withdrawal from sleep medication over a 2-week period, combined with the use of a substitute pill to maintain the ritual of nightly pill-taking, is appropriate and effective for long-term elderly users.
SENIOR CENTERS Shifting Student Paradigms
Authors: Schneiderman Janet U , Jordan-Marsh Maryalice , Bates-Jensen Barbara 
Published: May 2014

ABSTRACT
The purpose of this study was to evaluate an innovative service learning experience for new nursing students involving senior citizen centers. Junior nursing students (n - 128) were assigned in cohorts to one of five centers for a 5-week rotation. A questionnaire was administered post hoc to the students, teaching assistants, center directors, and a sample of senior citizens at each site. The majority of students believed the experience was a valuable part of the curriculum and saw prospects for community health nursing roles. However, they had concerns regarding losing time in acute care and relevance and number of assignments, and reported some difficulty in applying classroom content in the setting. Directors and senior citizens were universally positive about the experience. Student and teaching assistant reports were key in revising the curriculum. Revisions include logistics of the placement of the experience and assignments as well as incorporation of this experience within the community context.
Are Older Women Offered Adequate Health Care?
Authors: Blair Kathryn A , White Nancy 
Published: May 2014

ABSTRACT
The "graying of America" will have profound effects on the health care delivery system. With shrinking amounts of health care dollars, nurses and primary care providers need to promote health maintenance and disease prevention strategies that will foster healthier aging. This study was designed to examine the health promotion strategies of family practice physicians and residents. The target population was a sample of 201 women age 60 and older. The health maintenance issues were counseling about hormone replacement therapy (HRT), urinary incontinence (Ul), and immunizations. The results clearly demonstrated that older women were not adequately immunized or counseled about HRT or Ul. Nurses can play a pivotal role in changing these practices. Nurses can serve as advocates for older woman by encouraging them to request these services, or advanced practice nurses can provide these services.
Respite For CAREGIVERS: A Community-Based Model in a Rural Setting
Authors: Hayes Jill M 
Published: May 2014

ABSTRACT
Currently in the United States, 4 million Americans suffer from Alzheimer's disease (AD), and projections are that this population will increase to 7 million by the year 2040. Traditionally, care for these clients is provided by family, relatives, and friends - an informal caregiver network (ICN). Changing demographics in the United States are threatening this caring network. When these factors are coupled with the recent emphasis on cost containment in health care, caring for this client population has become a significant political, economic, and societal issue. Strategies must be developed to meet the needs of both the clients and their caregivers. Respite services have been identified as an effective strategy in the ongoing management of clients with AD. A model is proposed to provide community-based respite services in a rural setting in northeast Georgia. The need for respite services, along with barriers to the use of such services by clients and their caregivers, is described. Strategies to overcome barriers and provide needed services in a cost effective and sensitive manner are presented. Implications for nursing and related disciplines are discussed.
Comparison of Caregivers', Residents', and Community-Dwelling Spouses' Opinions About: Expressing Sexuality in an Institutional Setting
Authors: Gibson Margaret C , Bol Nancy , Woodbury M Gail , Beaton Catherine , Janke Corey 
Published: May 2014

ABSTRACT
Opinions regarding the appropriateness of elderly residents' sexual behaviors in a chronic care hospital and how to respond to inappropriate behaviors were surveyed. Study participation was open to all staff (N = 1,205), eligible residents (N = 182) and community-dwelling spouses (N = 103). Participation rates were 40% (residents), 42% (spouses), 34% (nursing staff), 50% (allied health staff), and 22% (support staff). Staff completed the questionnaire independently, while residents and spouses were offered self-completion or a structured interview. Almost all selected the interview. Residents and spouses were less tolerant than staff of residents' masturbating, engaging in sexual relationships, viewing sexual materials, and making sexual approaches to staff. Privacy was the primary determinant of appropriateness for behaviors for all groups. Staff and spouses were more likely to endorse counseling when behaviors were perceived as inappropriate than residents. Nurses endorsed counseling less frequently than allied health professionals and support staff. Nurses were more likely to have been approached sexually by a resident. Differences of opinion are interpreted in terms of cohort influences on values and contextual influences on behavior.
Minimum Data Set and Resident Assessment Instrument
Authors: Rantz Marilyn J , Popejoy Lori , Zwygart-Stauffacher Mary , Wipke-Tevis Deidre , Grando Victoria T 
Published: May 2014

Can Using Standardized Assessment Improve Clinical Practice and Outcomes of Care?
ABSTRACT
Regulating and standardizing the assessment of residents was envisioned by the 1986 Committee on Nursing Home Reform to have many advantages for facility management, government regulatory agencies, and clinical staff to evaluate changes in resident status and adjust the care plans accordingly. Standardized assessment data was viewed as a source of management information to be used to track case mix (i.e., acuity) of residents, allocate resources such as staff, and evaluate care quality. The Resident Assessment Instrument is a clinically relevant assessment process that can facilitate effective care planning, interventions, and quality improvement. It is a clinically complex process requiring care delivery systems developed by RNs to support the implementation of individualized care.
Individualized Interventions to Prevent Bed-Related Falls and Reduce Siderail Use
Authors: Capezuti Elizabeth , Talerico Karen A , Cochran Ina , Becker Honore , Strumpf Neville , Evans Lois 
Published: May 2014

ABSTRACT
Five categories of problems that often result in siderali use: memory disorder, impaired mobility, injury risk, nocturia/incontinence, and sleep disturbance. As nursing homes work toward meeting the Health Care Financing Administration's mandate to examine siderali use, administrators and staff need to implement interventions that support safety and individualize care for residents. While no one intervention represents a singular solution to siderali use, a range of interventions, tailored to individual needs, exist. This article describes the process of selecting individualized interventions to reduce bed-related falls.
OBSERVED BEHAVIORS of Patients With Probable Alzheimer's Disease Who Are Hospitalized for Diagnostic Tests
Authors: Day Nancy , Musallam Kathleen , Wells Mary 
Published: May 2014

ABSTRACT
This study examines observed behaviors of hospitalized patients with probable Alzheimer's disease (AD) undergoing invasive diagnostic procedures. Data was obtained from nursing documentation in the medical records of 30 patients, 10 in each stage of AD (i.e., mild, moderate, severe). In general, analysis of the data revealed that changes in behavior occurred immediately prior to, during, and following these procedures. Specifically, the moderately impaired patients showed the most significant curve over the 5-day observation period, while patients in the mildly impaired group showed a high peak of behavioral change on the test day. The severely impaired group of patients had a higher sustained level of activity throughout the 5-day period. Routine assessment of the patients' usual behaviors, caregivers' knowledge of the stage of disease, and awareness of the potential impact that diagnostics may have on cognitively impaired patients could help care providers decide what interventions most likely would lead to successful outcomes.
The Changing Role of Grandparenthood
Authors: Davidhizar Ruth , Bechtel Gregory A , Woodring Barbara C 
Published: May 2014

ABSTRACT
For many grandparents in America, caring for grandchildren has become a full-time responsibility that has led to multiple stresses. Raising grandchildren may cause financial stress, cramped living quarters, role restriction, and social isolation among this group. However, advantages to this role among grandparents can include greater life satisfaction and a positive influence on the other generations within the family. Nurses and other health providers can play an essential role in assisting grandparents caring for grandchildren by strategically building family strengths and cohesiveness.
MAMMOGRAPHY SCREENING for Older Women With and Without Cognitive Impairment
Authors: Messecar Deborah C 
Published: May 2014

ABSTRACT
No upper age limit exists for Medicare benefits for mammography screening, but benefits for women older than age 75 remain unclear. From a clinical perspective, it would be useful to know if there is an upper age limit for women beyond which screening for breast cancer will not extend life. Using a decision-analysis model, the author examined the utility of screening using cohorts of women age 75 to 79, 80 to 84, and 85 and older, with and without cognitive impairment. The analysis evaluated different scenarios of the benefit of biennial screening versus no screening for women who had no prior screening and women who had participated in a regular screening program. Screening increased Quality Adjusted Life Years (QALYs) at all ages. Marginal savings in life expectancy adjusted for quality of life for women with no prior screening ranged from 43.5 days for healthy 75 to 79-year-old women to 25.9 days for women older than age 85. Among cognitively impaired women who were never screened, savings ranged from 20 to 5.5 days for the three age cohorts. Biennial screening among women who had been screened continuously resulted in substantially smaller life expectancy savings, from 3.3 days for healthy individuals age 75 to 79 to less than 1 day for women older than age 85. Cost effectiveness analysis indicated the reduction in costs associated with managing recurrent disease gained by early diagnosis with mammography was greatest among the population with no prior screening. Although the increase in QALYs was consistently lower for cognitively impaired women than for their healthy counterparts, the presence of cognitive impairment did not alter the finding that screening increased QALYs.
Maintaining Health in Well Older Adults: Initiatives for Schools of Nursing and The John A. Hartford Foundation for the 21st century
Authors: Belza Basia , Baker Margaret Wooding 
Published: May 2014

ABSTRACT
In the past century, there has been a substantial increase in the number of older Americans and an increase in their life expectancy at birth. These trends will continue over the next century, marked by further increases in active life expectancy and marked changes in the racial and ethnic composition of the older population. While nursing has traditionally focused on the care of frail older individuals, most older adults-well older adults-enjoy a relatively high level of health and function. In this article, well older adults are defined as those with the physical, mental, social, and spiritual function or resources to meet the needs of everyday living. Recommendations for improving care of well older adults are provided, including reconceptualizing ways of thinking, expanding practice initiatives, building the science of nursing research in geriatrics and gerontology, developing education and training opportunities, and rethinking individual safety within the context of autonomy.
Nursing and Gerontology
Authors: McBride Angela Barron 
Published: May 2014

ABSTRACT
This article, originally prepared as a think piece for The John A. Hartford Foundation, explores the interrelationship between nursing and gerontology: strengths nursing brings to the area of aging; challenges that must be addressed both at the societal level and within the profession for nursing to achieve its full potential in gerontology; and strategies that might be adopted to maximize strengths and address identified gaps. These strategies include highlighting the heroic behaviors of the gerontologic nurse, increasing support for gerontologic advanced practice nursing, promoting collaborative gerontologic research, encouraging dissemination of nursing's knowledge base, and collaborating with foundations to promote self-care. It is proposed that nursing's research-practice agenda in the third millennium must be: preventing disease where possible; minimizing morbidity and maximizing quality of life when disease cannot be prevented, and having the wisdom to reconcile the two.
Enhancing Geriatric Nursing Scholarship: Specialization Versus Generalization
Authors: Mezey Mathy , Fulmer Terry , Fairchild Susan 
Published: May 2014

ABSTRACT
This article explores the relative merits of encouraging preparation of more nurses with specialization in geriatrics as compared to encouraging geriatric preparation among nurses whose major field of study is outside geriatrics. The article explores two approaches to examining capacity for geriatric nursing scholarship among nurse scholars not involved in geriatrics, and in schools of nursing with strength in research but with little geriatric research. The findings show an ongoing need to strengthen geriatric nursing as an area of specialization. Faculty prepared in geriatric nursing are underrepresented in schools of nursing, and only a small number of doctoral students specialize in geriatric nursing. Academic nursing programs with strength in geriatric nursing need ongoing support to maintain and expand current geriatric programs. Data support that encouraging individual non-geriatric nurse faculty and doctoral candidates to focus their work on areas of concern to geriatric nursing, and strengthening geriatrics in research-intensive schools of nursing that have not heavily invested in geriatric scholarship are viable options for strengthening academic geriatric nursing. Establishing mechanisms to attract nurse scholars working outside the scope of geriatric nursing to address clinical issues of concern to older adults offers promise in rapidly attracting new scholars to geriatric nursing.
What Is Your Life Like Now?: Loneliness and Elderly Individuals Residing in Nursing Homes
Authors: Hicks T J 
Published: May 2014

ABSTRACT
Loneliness has been associated with cognitive deterioration, social isolation, hopelessness, and the inability to perform independent activities of daily living. Three factors have been found to increase levels of loneliness among elderly individuals residing in a nursing home: lack of intimate relationships, increased dependency, and loss. Nurses in long-term care facilities are in a position to directly intervene with elderly residents. Individualized interventions will allow the resident to have greater well being and greater quality of life.
Facilitating End-of-Life Decision-Making: Strategies for Communicating and Assessing
Authors: Norton Sally A , Talerico Karen A 
Published: May 2014

ABSTRACT
End-of-life decision-making is often a difficult process and one that many elderly patients and their families will undergo. The grounded theory study of nurses, physicians, and family members (n = 20) reported in this article examined provider behaviors that facilitated the process of decision-making near the end of patients' lives. According to participants, providers who are experienced and comfortable are more likely to engage in communication and assessment strategies that facilitate end-of-life decision-making. Communication strategies included: being clear, avoiding euphemisms, spelling out the goals and expectations of treatment, using words such as "death" and "dying," and being specific when using such words as "hope" and "better." Assessment strategies included: assessing patients' physical conditions and end-of-life wishes, patients' and family members' understandings of the disease and prognosis, and their expectations and goals. An important first step for improved care is making explicit the provider's communicating and assessing strategies that facilitate end-of-life decision-making.