Geriatric Nursing Commons^™

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 …

Nurse Perception Of Care Of Hospitalized Older Adults – A Comparative Study Between Northern And Central Regions Of Portugal, João Paulo De Almeida Tavares, Alcione Leite Da Silva, Pedro Sá-Couto, Marie Boltz, Elizabeth Capezuti

Publications and Research

Objective: to analyze the relationship between the perceptions of nurses about geriatric care (GC) environment and geriatric nurses’ knowledge and attitudes according to unit type considering the northern and central regions of Portugal.

Method: a cross-sectional study was developed among 1068 Portuguese’s nurses in five hospitals. The instrument was Geriatric Institutional Assessment Profile – Portuguese version. The independent samples t-test was when the assumption of normality was verified, otherwise, the Mann-Whitney U test was used. The level of significance was 5%.

Results: the profile of perceptions of GC showed a relatively homogeneous pattern (no statistically significant results were found). For …

Role Of Domiciliary And Family Carers In Individualised Nutrition Support For Older Adults Living In The Community, Skye Marshall, Ekta Agarwal, Adrienne Young, Liz Isenring

Liz Isenring

Role Of Domiciliary And Family Carers In Individualised Nutrition Support For Older Adults Living In The Community, Skye Marshall, Ekta Agarwal, Adrienne Young, Liz Isenring

Skye Marshall

Role Of Domiciliary And Family Carers In Individualised Nutrition Support For Older Adults Living In The Community, Skye Marshall, Ekta Agarwal, Adrienne Young, Liz Isenring

Ekta Agarwal

The Effects Of 12 Weeks Of Instructor-Led Yoga Classes On Balance In Older Adults, Patricia C. Hart

Evidence-Based Practice Project Reports

Participation in a regular exercise program is an effective way to reduce and/or prevent a number of functional declines associated with aging (Chodzko-Zajo et al., 2009). Older adults are advised to participate in regular aerobic activity and practice muscle strengthening activities and exercise that maintains or improves balance (U.S. Department of Health and Human Service, [USDHHS], 2012). Less than one third of older adults engage in 30 minutes of low to moderate intense physical activity at least five days a week as recommended in current guidelines (USDHHS, 2012), and these guidelines fail to address losses in strength and flexibility seen …

Efficacy Of A Vitamin/Nutriceutical Formulation For Moderate To Late Alzheimer’S Disease: A Placebo-Controlled Pilot Study, Ruth Remington, A Chan, Thomas Shea

Ruth Remington

Recent studies demonstrated efficacy of a vitamin/ nutriceutical formulation (folate, vitamin B12, alpha-tocopherol, S-adenosyl methionine, N-acetyl cysteine, and acetyl-L-carnitine) for mild to moderate Alzheimer's disease. Herein, we tested the efficacy of this formulation in a small cohort of 12 institutionalized patients diagnosed with moderate-stage to later-stage Alzheimer's disease. Participants were randomly separated into treatment of placebo groups. Participants receiving the formulation demonstrated a clinically significant delay in decline in the Dementia Rating Scale and clock-drawing test as compared to those receiving placebo. Institutional caregivers reported approximately 30% improvement in the Neuropyschiatric Inventory and maintenance of performance in the Alzheimer's Disease …

Dehydration Reduction In The Community Dwelling Older Adult: Perspectives Of Community Health Care Providers, Lisa Abdallah, Ruth Remington, S Houde, L Zhan, Karen Melillo

Ruth Remington

Dehydration is a common problem among older adults and can negatively affect their health. This crosssectional descriptive study used survey findings and focus group interviews to investigate dehydration problems among community-dwelling older adults and to identify strategies perceived to be helpful in preventing dehydration in this population. The survey sample (n = 18) and four focus groups (n = 36) included health care providers in the northeast United States from provider agencies representing emergency care, home care, primary care, and community health care. Survey findings indicated that 89% of participantsidentify dehydration as a problem affecting older adults, and 94% noted …

Interpreting Laboratory Values In The Rehabilitation Setting, Jane Flanagan, Karen Melillo, Lisa Abdallah, Ruth Remington

Ruth Remington

Treating patients in rehabilitation settings is becoming increasingly complex for a variety of reasons, such as the presence of several comorbid conditions, increased age, and earlier discharge from acute care facilities. As a result, careful monitoring and assessment by nurses is essential. Laboratory testing can improve the assessment when nurses are able to recognize when and what should be reported and what types of treatments may be needed. Understanding what laboratory findings should be monitored and what added assessment criteria are necessary can be daunting. Therefore, this article reviews critical laboratory and other assessment findings in light of common health …

Apple Juice Improved Non-Cognitive Symptoms In Moderate- To Late-Stage Alzheimer’S Disease In An Open-Label Pilot Study, Ruth Remington, A Chan, A Lepore, E Kotlya, Thomas Shea

Ruth Remington

Preclinical studies demonstrate that apple juice exerts multiple beneficial effects including reduction of central nervous system oxidative damage, suppression of Alzheimer's disease (AD) hallmarks, improved cognitive performance, and organized synaptic signaling. Herein, we initiated an open-label clinical trial in which 21 institutionalized individuals with moderate-to-severe AD consumed 2 4-oz glasses of apple juice daily for 1 month. Participants demonstrated no change in the Dementia Rating Scale, and institutional caregivers reported no change in Alzheimer's Disease Cooperative Study (ADCS)-Activities of Daily Living (ADL) in this brief study. However, caregivers reported an approximate 27% (P < .01) improvement in behavioral and psychotic symptoms associated with dementia as quantified by the Neuropsychiatric Inventory, with the largest changes in anxiety, agitation, and delusion. This pilot study suggests that apple juice may be a useful supplement, perhaps to augment pharmacological approaches, for attenuating the decline in mood that accompanies progression of AD, which may also reduce caregiver burden.

A Vitamin/Nutriceutical Formulation Improves Memory And Cognitive Performance In Community-Dwelling Adults Without Dementia, A Chan, Ruth Remington, E Kotlya, A Lepore, J Zemianek, Thomas Shea

Ruth Remington

Adults of both genders without dementia consumed a nutriceutical formulation ("NF," consisting of folic acid, B12, Vitamin E, S-adenosylmethionine, N-acetyl cysteine and Acetyl-L-carnitine), previously shown to improve cognitive performance in Alzheimer's disease, or placebo. Participants receiving NF but not placebo improved statistically and clinically in the California Verbal Learning Test II and the Trail-Making Test. Both groups improved further during a 3-month open-label extension. Additional individuals displayed identical improvement during a separate 6-month open-label trial. Performance declined to baseline following withdrawal of NF, and statistically improved when participants resumed taking NF. Additional participants receiving NF but not placebo demonstrated improvement …

Managing Problem Behaviors Associated With Dementia, Ruth Remington, Lisa Abdallah, Karen Melillo, Jane Flanagan

Ruth Remington

The older adult with dementia who exhibits problem behaviors is likely to be experiencing physical or psychological distress. Both can negatively affect the health, rehabilitation and quality of life for the older adult. Managing problem behaviors can challenge the skills of the most experienced nurse. Being able to identify the origins of these behaviors can help caregivers respond in a way that will achieve behavioral management and preserve the dignity of the older adult. This article presents some practical measures to assist nurses with minimizing the negative effects of dementia-associated problem behaviors in older adults.

The Clock-Drawing Test: Time For A Change?, A Chan, Ruth Remington, J Paskavitz, Thomas Shea

Ruth Remington

Clock-drawing tests are simple and rapid screening devices for dementia. It was observed that individuals (" . . .make the clock read 12:45") or an analog prompt (" . . .quarter to 1"), whereas individuals >70 years of age showed improved performance with an analog prompt. The digital prompt has routinely been used to force participants to recode the prompt via conceptualization. Differential scoring across a range of ages has likely derived from the advent and increase of digital clocks with the younger segment of the population. This implies the need for as-yet undetermined alteration in the nature of prompts …

Effects Of Emergency Department Care Coordination Team Referrals In Older People Presenting With A Fall, Kristie J Harper, Nicholas P. Gibson, Annette D Barton, Antonio C Petta, Sara K Pearson, Antonio Celenza

Research outputs 2013

Objectives: The study aims to describe the characteristics of patients presenting to an ED with a fall and evaluate multidisciplinary Care Coordination Team (CCT) referrals on patient outcomes. Methods: A single-centred retrospective analysis of electronic data at an adult tertiary hospital was performed using data from 2004 to 2009 of presentations for patients aged 65 years or over with a fall. The primary outcome measure was representation to hospital within 30 days, comparing patients referred to CCT and those not referred. Secondary outcomes were differences in demographic characteristics, mode of arrival, triage score and readmission. Results: The proportion of ED …

Interdisciplinary Education In Emergency Preparedness: Assuring The Safety Of Aging Populations, Linda L. Strong, Dori Taylor Sullivan

Nursing Faculty Publications

Aging is a global phenomenon. It impacts unequally, with this inequality attributable to such factors as gender, culture, education, socioeconomic status and access to primary and preventive care. Access to care and the quality of that care are significantly impacted by governmental support and regulations. Most elderly live in developed countries; however, for a significant number life is not free of stress and struggle to meet basic needs. Elders in developing countries face even more challenges. Natural and man-made disasters increase the vulnerability of these populations through potential disruption of critical services. Currently there is a paucity of health and …