Medicine and Health Sciences Commons^™

Improving Depression Screening Completion Rates For Medicare Patients In A Primary Care Setting, Kenneth J. Haluska

Evidence-Based Practice Project Reports

The United States Preventative Services Task Force recommends screening the general adult population for depression (Siu et al., 2016). Despite increasing clinical practice guidelines recommending depression screening, only 40-50% of depressed older adults are recognized and treated (Phoh et al., 2017). The purpose of this evidence-based practice (EBP) project was to implement a medical assistant (MA) depression screening protocol, using the PHQ-9 and staff education, to improve depression screening completion rates in Medicare patients in a primary care setting. An exhaustive literature search of eight databases yielded 14 pieces of evidence that made recommendations for best practice. The evidence was …

Use Of The Prepare Tool To Increase Completion Rates Of Advance Care Planning Documentation, Janella Thompson

Student Scholarly Projects

Practice Problem: One in three adults aged 55 and older admitted to the hospital lack advance care planning. Patients without advance care planning may not receive treatment that reflects their personal values, wishes, and preferences

PICOT: The PICOT question that guided this project was in adults 65 years or older (P), how does the implementation of a patient-centered web-based advance planning tool kit (I) compared to the usual practice of addressing advance care planning (C), affect the completion rate of advance care planning documentation (O) within 10 weeks (T).

Evidence: The current evidence has demonstrated that advanced care …

Efficacy Of Pharmacologic Treatment For Orthostatic Hypotension In The Elderly Population, Abigail Moeller

Physician Assistant Scholarly Project Papers

The purpose of this literature review is to determine the efficacy and safety of pharmacologic treatments for orthostatic hypotension (OH), with an emphasis on researching the elderly population. In this review, three electronic search databases were utilized including PubMed, Google Scholar, and Dynamed from the years 1997 to 2019. Several keywords were used during the search. Criteria for chosen articles included that the article must be peer-reviewed, the studied population must have a median age of at least 50 years-old, at least 20 subjects must be involved, and the study must be published after the year 1995. The specific pharmacologic …

Rural And Urban Differences In Vegetable And Fruit Consumption Among Older Cancer Survivors In The Deep South: An Exploratory Cross-Sectional Study, Harleen Kaur

All ETDs from UAB

Background: Rural Americans have poorer overall health and physical functioning than their urban counterparts. A varied diet, rich in vegetable and fruit (V&F) consumption may improve health; however, little is known about rural-urban differences in V&F consumption, especially in older cancer survivors. Objective: To assess differences in V&F consumption among older cancer survivors residing in urban- and rural-designated areas, and explore whether differences exist by sex, race, and cancer type. Design: This was a cross-sectional secondary analysis. Participants/setting: Screening data from the Harvest for Health trial was obtained on 731 Medicare-eligible cancer survivors across Alabama. Main outcome measures: V&F consumption …

Implementation Of Post Falls Huddles In Skilled Nursing Facility, Princess Lomax

Evidence-Based Practice Project Reports

The purpose of this paper is to discuss the quality improvement project, implementation of the post fall huddle in a long-term care facility. Falls are the most common problem in adults 65 years and older. Falls in this population can have devastating effects, often leading to significant changes in morbidity or death. Adults in long term care settings have an increased risk of falling and having a subsequent fall due to an acute illness, weakness, or confusion (CDC, 2015). At the skilled facility, there has been a significant increase in hospitalizations due to injuries sustained from falls. To address this …

Elucidation Of The Mechanisms By Which Anesthetics Induce Blood-Brain Barrier Breakdown And Delirium In The Elderly, George A. Godsey Ii

Graduate School of Biomedical Sciences Theses and Dissertations

Delirium is a highly prevalent neuropsychiatric or neurocognitive disorder that presents a major problem to modern healthcare. Patients suffering from delirium normally have a worse prognosis, prolonged hospital stay, increased hospital cost, long-term cognitive impairment, and higher mortality rates. Many factors can predispose one to develop delirium, which makes treating this disorder a daunting task. Unfortunately, delirium is the most common psychiatric syndrome found in the hospital setting. In fact, a form of delirium known as postoperative delirium (POD) is one of the most common postoperative complications faced by elderly patients undergoing surgery.

POD is a major problem in modern …

Using Digital Health Technology To Optimise Older People’S Pain Self-Management Capabilities: A Mixed Methods Study (The Digitech Pain Project), Priyanka Bhattarai

Theses

Background

Arthritic pain is a major cause of illness and disability among older people. As the use of smartphones and apps increases in the lives of older people, there is an opportunity to explore the role of these apps in helping older people better manage their arthritic pain.

Aim

To explore the feasibility and acceptability of older people using an arthritic pain selfmanagement app to improve their pain symptoms.

Methods

A parallel convergent, mixed methods design underpinned by Bandura’s Self-Efficacy Theory and the Technology Acceptance Model 2; comprising of the following five studies:

(i) Study 1a: an integrative review;

(ii) …

A Group Protocol For Promoting Wellness In Rural Community-Dwelling Older Adults, Emily Bachmeier, Laurel Busch

Occupational Therapy Capstones

Purpose: In the United States, there are currently 46 million citizens aged 65 and older. This number is projected to more than double by the year 2060 (Mather, 2016). As the elderly population continues to grow, the need for evidence-based, client centered prevention programs for community-dwelling older adults becomes more crucial to promote independence and preserve well-being in the community. Older adults living in rural areas are at an even higher risk of losing independence secondary to decline in activity tolerance, which further elevates their need for targeted interventions (Park, Kim, & Lee, 2015). Creating a preventative program to maintain …

Physical Therapy Treatment For A Patient With A Hip Fracture And Cognitive Impairments: A Case Report, Tracie Boehmlehner

Physical Therapy Scholarly Projects

Background and Purpose: As the population shifts to include higher numbers of people in the elderly population, diseases and pathologies associated with geriatric populations will also increase. Two of these conditions are cognitive impairment and hip fractures. Hip fractures can be costly and life altering injuries. Treating patients with both of these conditions can pose a unique challenge to healthcare workers.

Case Description: The patient in this case study is a 78 year-old female who suffered a hip fracture secondary to a fall with a hip herniarthroplasty completed. She had many co-morbidities that are typical of an aging person such …

A Website Designed To Equip Occupational Therapists With Information And Strategies For Holistically Addressing Sexual Activity With The Geriatric Population, Amber Fernandez, Ashleigh Mora

Occupational Therapy Capstones

As individuals age, they are likely to experience occupational deprivation. Occupational deprivation occurs in many forms. Many older adults experience occupational deprivation relating to the activity of daily living, sexual activity. Older adults experience many age-related changes, which impacts their ability to engage in sexual activity. Health care professionals have a responsibility to ensure older adults are able to engage in safe sexual practices. Yet, healthcare professionals, including occupational therapists, are not addressing this need with their clients in a routine manner. A literature review was conducted in order to gain a comprehensive understanding of all the barriers older adults …

Occupational Therapy Practitioners' Knowledge And Perception Of The Value Of Environmental Adaptations For Nursing Home Residents With Neurocognitive Disorders, Hannah Fiser

Occupational Therapy Capstones

The purpose of this independent study was to evaluate occupational therapy practitioners’ perceptions of the efficacy of certain environment-based intervention types when utilized with nursing home residents who present with neurocognitive disorders. A non-experimental research design in an online survey format was utilized. An invitation to take the online survey was submitted to 56 occupational therapy (OT) practitioners working in skilled nursing facilities. The online survey was comprised of questions addressing awareness/use and perception of efficacy of environment-based intervention methods. Seventeen responses were received. The majority of respondents reported awareness and use of the 20 environment-based intervention methods. Overall, respondents …

Wellness Programming For Men In Long-Term Care, Katie Hautman, Ashley Heinze

Occupational Therapy Capstones

Introduction: The purpose of this project was to develop a wellness guide for staff to implement in long-term care (LTC), to increase participation of meaningful activities and well-being for male residents of all abilities, both physically and psychosocially.

Methodology: A literature review was conducted to understand the need for activities of male residents in LTC. Sources included: online databases, textbooks, and government websites. The Canadian Model of Occupational Performance and Engagement (CMOPE) was selected to direct the development of the program guide. The CMOP-E promotes engagement in occupations and enablement of occupational performance, both of which are important for male …

Using Leisure As A Therapeutic Activity To Enhance Health, Well-Being, And Quality Of Life Among Long Term Care Residents, Olivia Mayasich, Alexis Tyce

Occupational Therapy Capstones

Purpose The purpose of this scholarly project is to address health, well-being, and quality of life with the use of leisure activities as modalities with residents in long term care (LTC) facilities.

Methodology The results of a thorough literature review supported the need for a program to address leisure participation in residents in LTC facilities. An abundance of literature supporting participation in leisure to enhance health, well-being, and quality of life emerged from the literature review, revealing an obvious gap between literature and practice. The information gathered in the literature review helped guide the development of a program manual to …

Standard And Cognitive Four Square Step Test (Fsst), Renee Hoffman, Hannah Bucholz

Physical Therapy Scholarly Projects

Background/Purpose: The Four Square Step Test (FSST) measures dynamic standing balance and agility and was developed to identify older adults at risk for falls. It has a cognitive component for remembering the stepping sequence but has never been tested with an additional cognitive task. The purpose of this study was to collect normative data for the FSST and Cognitive FSST in community dwelling adults for various age groups.

Materials/Methods: Eighty-seven community-dwelling adults (55 females, 32 males) between the age 21 and 86 (48.22 years) were included in the study. Participants completed a fall risk checklist and a cognitive screen prior …

Effects Of Pole Walking On Older Adults Following Six Weeks Of Training, Samantha Forsch, Raevyn Haugland

Physical Therapy Scholarly Projects

Introduction: Age-related changes in adults over 60 include reduced mobility and function as well as an increase in frailty. Conventional walking has been shown to be an effective physical activity to maintain mobility and improve function and overall health and fitness. Specifically, walking speed has been identified as a crucial predicting factor for fall risk and decreased functional mobility. For this reason, clinicians considered the element of walking speed as the sixth vital sign. Pole walking has gained popularity over the years and may provide additional benefits, when compared to conventional walking, such as improved stride and step length, faster …

Vacationing Older Adults, Breanna Taralson, Brittany Winter

Occupational Therapy Capstones

Introduction: This scholarly project was conducted to explore the aspects of vacationing in older adults and how age-related changes seen within this population can impact decisions while traveling. The purpose of this project was to create a resource guide for older adults to help navigate the vacationing process.

Methodology: A literature review was conducted using various sources including: online databases, books on travel and vacationing, personal communication via informal interview, and through major travel corporation websites. Information from these sources was then compiled to create a resource guide for older adults.

Results: Information found within the literature …

Conservative Treatment Of A 58 Year-Old Male Referred To Physical Therapy With A Knee Sprain And Knee Osteoarthritis, Chase Pruitt

Physical Therapy Scholarly Projects

Background and Purpose: Knee osteoarthritis (OA) is a common condition in people over 50. Although there may be an association between acute knee injuries and knee OA later in life, the occurrence of acute knee injuries in patients with existing OA is less clear. The purpose of this case study is to evaluate the effectiveness of an impairment based therapy program in an individual with an acute knee injury and knee OA.

Case Description: This case follows a 57 year old male referred to physical therapy with an acute knee sprain and tri-compartmental knee OA. Treatment lasted 7 sessions …

Generationactive: Creating Healthier Communities Two Generations At A Time, Jerrica Thiel, Mallory Manecke

Occupational Therapy Capstones

Obesity has become an epidemic across all ages, as the prevalence of obesity has nearly tripled over the last 40 years (World Health Organization, 2017-a). Obesity can have a detrimental impact on the health and future of Americans, as many diseases are correlated with obesity. Diabetes, which often occurs secondary to obesity and is the 7th leading cause of death in America, is similarly on the rise (CDC, 2012). To combat these issues, there is a great need for a health promotion initiative that provides individuals of all ages an opportunity to learn about health and wellness, to take steps …

Effects Of Long-Term Participation In Tennis On Cognitive Function In Elderly Individuals, Scott Culpin

Theses: Doctorates and Masters

Many studies have reported the relationship between exercise and cognition with conflicting results. This may be due to differences in intervention durations, session lengths, intensities, and type of exercise. It has been suggested that exercises requiring greater cognitive demand such as football, basketball and racquet sports, are protective against cognitive decline, compared to less cognitively demanding exercises such as swimming, cycling and running, however, research concerning exercise types are currently limited. The present study tested the hypothesis that elderly individuals who had been regularly playing tennis more than 10 years, would have greater cognitive function than those who had been …

Wise And Well: A Pilot Study On The Effects Of Providing A Wellness Group Protocol To Enhance Occupational Fit Among Rural Community Dwelling Elderly Women, Brianna Berendt, Carly Hills

Occupational Therapy Capstones

Problem: There is a need for rural services for community-dwelling women due to a lack of resources, transportation, and social opportunities (Bacsu et a!., 2016; Averill, 201 2). Likewise, Shimada et a!. (2014) emphasized the impact and causes of social isolation on elderly individuals and how important it is for elderly individuals to establish a support system when facing challenges throughout later life. A third problem was described by Choi et a!. (2013) in that elderly individuals may experience a loss of independence and functional decline can result from being physically inactive. This indicates that there are increased health risks …

Lived Experience Of Individuals Who Had A Disruption In Ability To Drive, Shelby Hoskinson, Graydon Larsen

Occupational Therapy Capstones

Purpose: Driving is both a highly valued occupation within the United States and an occupation that is frequently addressed by occupational therapists. According to the CDC (2017) there are more than 40 million older drivers ages 65 years or older within the United States. There is extensive research pertaining to the value of the occupation of driving as well as evaluation and treatment approaches for the occupation of driving following an injury or illness. While driving is sometimes the best option after an injury or illness, there are situations when returning to driving is not realistic or safe for the …

Educating Caregivers In Assisted Living Facilities (Alfs) Who Care For People With Dementia, Rodney Palmer, Ashley Palmer

Occupational Therapy Capstones

It is estimated that approximately 40-71% of residents living within assisted living facilities (ALFs) have a form of dementia or other cognitive impairment (Harris- Kojetin et al., 2016; Zimmerman, Sloana, & Reed, 2014). There is also evidence that suggests that caregivers working within ALFs have inadequate knowledge on how to care for a resident diagnosed with dementia (Hughes, Bagley, Reilly, Burns, & Challis, 2008; McKenzie, Teri, Pike, LaFazia, & Van Leynseele, 2012; Sharpp, Kayser-Jones, & Young, 2012; Zimmerman et al., 2014). The authors of this scholarly project created an instructional manual that can be used to train caregivers within ALFs …

The Effectiveness Of "Stepping On" In Reducing Fall Risk In The Elderly Using The 30-Second Chair Stand Test, Brianna Albrecht

Physical Therapy Scholarly Projects

Background: One-third of all adults over the age of 65 years of age falls each year. Falls cost patients financially, physically, and emotionally. Balance and strength deficits contribute to increasing an individual's fall risk. Studies have shown the efficiency of community-based exercise and education programs on reducing the risk of falling.

Objective: The purpose of this study was to determine whether participants in Stepping On experienced an improvement in balance and confidence following completion of the program. The study also evaluated the correlation between self-perceived risk of falling on the CDC Fall Risk Survey and their actual risk …

Evaluation Of Program Satisfaction, Quality Of Life, Strength, And Fall Risk Of Community-Dwelling Older Adults Participating In A Community Exercise Program: Part 2, Marissa Adolphson, Roy Nelson, Jenna Wyffels

Physical Therapy Scholarly Projects

Background and Purpose: Bone Builders is an exercise program that incorporates both lower and upper extremities and is specifically designed for the older adult population. It was originally created for those that wanted to reduce their risk of osteoporosis, but currently there is no evidence that demonstrates these effects. However, exercises that are completed in the class are those that target causes of fall risk such as strengthening of hip abductors and balance activities. Participants have also reported that benefits of the class include improved balance, increased energy and mobility, and social support. Our study consisted of testing the …

Perceptions Of Wellness Among Community Dwelling Older Adults, Sara Johnson, April Schmiesing

Occupational Therapy Capstones

Most older adults prefer to age in place where they are more likely to experience greater health benefits and cost savings as opposed to living in skilled care facilities. Literature supports the role of occupational therapy in community-based wellness programming that helps older adults age in place; however, there is a need to conduct needs assessments to inform wellness program topics and activities. This study explores health and wellness needs of older adults living in a low-income, senior housing complex in order to inform current health and wellness programming provided at this site.

Researchers used a non-experimental, cross-sectional survey study …

Total Knee Arthroplasty Rehabilitation: Case Report, Allen Kennedy

Physical Therapy Scholarly Projects

Background and Purpose: Osteoarthritis (OA) of the knee is a common problem in the world population and total knee replacement has become the gold standard for repair when the OA becomes severe enough. Total knee replacement, however, is not the complete answer to knee OA. Without rehabilitation these patients may struggle to be fully functional. The purpose of this case study was to describe the rehabilitation of a geriatric patient who underwent TKA and benefited from the use of hydrotherapy in his recovery.

Case Description: This report will look at the rehabilitation of one 73-year-old male patient and interventions …

Effectiveness Of The Timed Up And Go (Tug) Test In Assessing Fall Risk In Community-Dwelling Elders Participating In The Stepping On Program, Megan Shanahan

Physical Therapy Scholarly Projects

Background: The Timed Up and Go (TUG) is intended to predict fall risk through assessment of balance, functional mobility, and gait in community-dwelling adults age 65 and older. The Stepping On program aims toward fall prevention through education, exercise, and shared experiences among participants. Previous evidence has displayed positive, significant results for Stepping On and the TUG, indicating use of the assessment to track participants' progress in the program.

Objective: The purpose of this study was: 1) to determine if the Stepping On program decreases fall risk in community-dwelling elderly individuals as measured by the TUG test, 2) …

Evaluation Of Fall Risk, Functional Mobility, And Quality Of Life Changes Of Community-Dwelling Older Adults With Parkinson's Disease Participating In A Community Exercise Program: Part Ii, Lauren Trudel, Courtney Mcdonald, Brittany Bleichner

Physical Therapy Scholarly Projects

Purpose/Hypothesis: As a person ages, the risk of a fall increases. Parkinson Disease (PD) is most commonly seen in the elderly population, which presents with symptoms such as bradykinesia, decreased balance, tremors, postural instability, and muscle weakness. These symptoms are associated with an increase in falls; therefore, a person with PD is more susceptible to falls than the average elderly individual. Exercise has been shown to combat those symptoms affecting people with PD. This study is an extension of a previous study, which examined the effect of a community based exercise program, for people with PD, on quality of …

A Health Care Provider Training Guide To Enhance Cultural Competency In Long-Term Care, Julia Mcbrien, Ashley Prososki

Occupational Therapy Capstones

The population of adults over the age of 65 in the United States is steadily increasing and becoming more diverse. Older adults are the greatest consumer of health care services, and they have unique health care needs. One notable health care need pertains to cultural beliefs and wants. When health care providers address the diverse needs of older adults, health outcomes improve for the client and communication across the interprofessional team improves. Therefore, the students of this scholarly project created a series of three, 50-minute long training sessions focused on training health care providers how to be culturally competent in …

Addressing Sleep Deficiencies In Older Adult Residents Of Long-Term Care Facilities: Presenting A Flowchart For An Interdisciplinary Approach, Peter Owens, Tavin Deru

Occupational Therapy Capstones

There is a growing population of older adults, or those people over 65 years old in long term care (LTC) facilities who report sleep deficiencies at a heightened rate, leading to decrease function, cognition, and social participation while increasing mortality, morbidity and the risk of falling (Booth & McMilliam, 2009; Cipolli, Mazzetti, & Plazzi, 2013; Crowley, 2011; Dzierewski et al., 2014; Helbig et al., 2013; Kuck, Pantke, & Flick, 2015). Occupational therapists (OTs) offer non-pharmacological sleep interventions in the long-term care facilities but are not present at many relevant sleeping times. This scholarly project is a flow chart aid to …