Geriatrics Commons^™

Advanced Practice Nurses Knowledge And Use Of Fall Prevention Guidelines, Katherine Hays

Doctor of Nursing Practice Scholarly Projects

Falls are a significant public health issue resulting in a significant economic and social burden on society. Specific strategies are available that can reduce the risk of falling for older adults age 65 and older; however, providers have failed to integrate these guidelines into clinical practice (Rubenstein, Solomon & Roth, 2004; Chou, Tinetti, King, Irwin, & Fortinsky, 2006; Jones, Ghosh, Horn, Smith, & Vogt, 2011). The CDC has published the STEADI toolkit, a healthcare resource for integrating fall prevention guidelines into clinical practice; but little information is available on the knowledge and use of the STEADI toolkit by Advance Practice …

Medical Crises In Older People: Cohort Study Of Older People Attending Acute Medical Units, Developmental Work And Randomised Controlled Trial Of A Specialist Geriatric Medical Intervention For High-Risk Older People; Cohort Study Of Older People With Mental Health Problems Admitted To Hospital, Developmental Work And Randomised Controlled Trial Of A Specialist Medical And Mental Health Unit For General Hospital Patients With Delirium And Dementia; And Cohort Study Of Residents Of Care Homes And Interview Study Of Health-Care Provision To Residents Of Care Homes, John Gladman, Rowan Harwood, Simon Conroy, Pip Logan, Rachel Elliot, Rob Jones, Sarah Lewis, Jane Dyas, Justine Schneider, Davina Porock, Kristian Pollock, Sarah Goldberg, Judi Edmans, Adam Gordon, Lucy Bradshaw, Matthew Franklin, Katherine Whittamore, Isabella Robbins, Aidan Dunphy, Karen Spencer, Janet Darby, Lukasz Tanajewski, Vladislav Berdunov, Georgios Gkountouras, Pippa Foster, Nadia Frowd

Publications and Research

Background: This programme of research addressed shortcomings in the care of three groups of older patients: patients discharged from acute medical units (AMUs), patients with dementia and delirium admitted to general hospitals, and care home residents.

Methods: In the AMU workstream we undertook literature reviews, performed a cohort study of older people discharged from AMU (Acute Medical Unit Outcome Study; AMOS), developed an intervention (interface geriatricians) and evaluated the intervention in a randomised controlled trial (Acute Medical Unit Comprehensive Geriatric Assessment Intervention Study; AMIGOS). In the second workstream we undertook a cohort study of older people with mental health problems …

Use Of Dietary And Herbal Supplements In Older Adults With Osteoarthritis, Sharon Denise Mcdonald

Dissertations

Over the past several decades, older adults with Osteoarthritis (OA) have increasingly used more natural products in an effort to manage chronic pain. The theoretical framework for this study was the Lazarus and Folkman transactional theory of stress and coping. This framework was chosen based on the belief that older adults with OA are taking natural products as an active problem solving coping strategy to manage the pain, disability, and alterations they experience in their health related quality life including functional status, physical symptoms, emotional health, and social functioning. Older adults also take prescription medications for Osteoarthritis and a variety …

Connecticut's Elderly Population: An In-Depth Analysis Of Current And Future Trends In Elder Care, With A Focus On Dementia And Cognitive Decline, Emily J. Snodgrass

Honors Scholar Theses

The aging population in Connecticut currently represents ~15% of the state’s population but is anticipated to rapidly increase over the next 20 years. My thesis is an examination of the types of interventions and programs currently available for elderly persons with memory impairment and cognitive decline, as well as the challenges associated with caring for a larger elderly population. Data collected from interviews with CT healthcare and research professionals representative of the diverse specialties of aging together with an analysis of current research literature are used to demonstrate the importance of continued research and expansion of appropriate and accessible services …

Long Term Care Nurses' Knowledge And Perceived Competency Of Palliative Care, Carol Evans

Doctor of Nursing Practice Technical Reports

Background: Palliative care is considered a right for human beings. By 2040, it is estimated that 40% of the 65 years of age and older population in the United States will die in long term care (LTC) facilities. Because of the chronicity of the geriatric population’s medical conditions, the patients may require end-of-life (EOL) care. Numerous LTC facilities are located in rural areas which may create a disparity in the provision of quality EOL care.

Methods: A quantitative descriptive cross-sectional design was utilized. The purpose of this study was to examine rural and urban nurses’ knowledge of palliative care and …

Search Strategies Used By Older Adults In A Virtual Reality Place Learning Task, Rebecca L. Davis, Catherine Weisbeck

Peer Reviewed Articles

Purpose of the study: Older adults often have problems finding their way in novel environments such as senior living residences and hospitals. The purpose of this study was to examine the types of self-reported search strategies and cues that older adults use to find their way in a virtual maze

Design and Methods: Healthy, independently living older adults (n = 129) aged 55–96 were tested in a virtual maze task over a period of 3 days in which they had to repeatedly find their way to a specified goal. They were interviewed about their strategies on days 1 and 3. …

Polypharmacy Practice Inquiry Project, Mary T. Skinner

DNP Projects

“The impending crisis, which has been foreseen for decades, is now upon us.The nation needs to act now to prepare the health care workforce to meet the care needs of older adults.” Institute of Medicine.

Given the rising tide of people over the age of 65, taking multiple medications or polypharmacy is a becoming more prevalent in older adults. Unfortunately, there are many negative consequences associated with polypharmacy. Specifically, this burden has been associated with greater health care costs and an increased risk of adverse drug events, drug-interactions, medication non-adherence, reduced functional capacity and multiple geriatric syndromes including cognitive impairment. …

A Program For Review Of Residents On Anti-Psychotic (Ap) Medications In A County Owned Nursing Facility, Catherine M. Glew Bm, Bs, Cmd, Beth Berklite Rn, Adon, Terri Bauer Rn

Department of Medicine

No abstract provided.

Care In Specialist Medical And Mental Health Unit Compared With Standard Care For Older People With Cognitive Impairment Admitted To General Hospital: Randomised Controlled Trial (Nihr Team Trial), Sarah E. Goldberg, Lucy E. Bradshaw, Fiona C. Kearney, Catherine Russell, Kathy H. Whittamore, Pippa E R Foster, Jil Mamza, John R F Gladman, Rob G. Jones, Sarah A. Lewis, Davina Porock, Rowan H. Harwood

Publications and Research

Objective To develop and evaluate a best practice model of general hospital acute medical care for older people with cognitive impairment.

Design Randomised controlled trial, adapted to take account of constraints imposed by a busy acute medical admission system.

Setting Large acute general hospital in the United Kingdom.

Participants 600 patients aged over 65 admitted for acute medical care, identified as “confused” on admission.

Interventions Participants were randomised to a specialist medical and mental health unit, designed to deliver best practice care for people with delirium or dementia, or to standard care (acute geriatric or general medical wards). Features of …

Forging A Niche To Strengthen The Inpatient Geriatric Service Line - Lessons From The Field, Tracie Heckman Msn, Rn, Cmsrn, Carolyn L. Davidson Rn, Phd

Patient Care Services / Nursing

No abstract provided.

Value Of A Graduate Gerontology Certificate Versus A Masters Degree, Janet S. Hahn

Academic Leadership Academy

The WMU Center for Gerontology was established in 2010 and builds on a strong tradition of gerontology education offered at WMU from the late 1970s to 2004. The undergraduate minor has been revised and is again offered. The previous graduate certificate in gerontology has not yet been reestablished.

This project sought to determine the relative value of a graduate certificate in gerontology vs. a masters degree in gerontology.

Successful Aging And The Epidemiology Of Hiv, David E. Vance, Teena Mcguinness, Karen Musgrove, Nancy Ann Orel, Pariya L. Fazeli

Gerontology Faculty Publications

By 2015, it is estimated that nearly half of those living with HIV in the US will be 50 years of age and older. This dramatic change in the demographics of this clinical population represents unique challenges for patients, health care providers, and society-at-large. Fortunately, because of highly active antiretroviral therapy (HAART) and healthy lifestyle choices, it is now possible for many infected with HIV to age successfully with this disease; however, this depends upon one’s definition of successful aging. It is proposed that successful aging is composed of eight factors: length of life, biological health, cognitive efficiency, mental health, …

Improving The Quality Of Information Sent To Primary Care Physicians For Patients Discharged From Nursing Facilities, Catherine M. Glew Bm, Bs, Cmd, Anne M. Yawman Md

Department of Medicine

No abstract provided.

The Mds Mortality Risk Index: The Evolution Of A Method For Predicting 6-Month Mortality In Nursing Home Residents, Davina Porock, Debra Parker-Oliver, Gregory F. Petroski, Marilyn Rantz

Publications and Research

Background: Accurate prognosis is vital to the initiation of advance care planning particularly in a vulnerable, at risk population such as care home residents. The aim of this paper is to report on the revision and simplification of the MDS Mortality Rating Index (MMRI) for use in clinical practice to predict the probability of death in six months for care home residents.

Methods: The design was a secondary analysis of a US Minimum Data Set (MDS) for long term care residents using regression analysis to identify predictors of mortality within six months.

Results: Using twelve easy to collect …

Knowledge Of Pain Management In Older Adults As A Content Area For Continuing Professional Education For Licensed Nurses, Wanda Cleveland Dubuisson

Dissertations

The research of the last 30 years has revealed the inadequacy of pain management in the older adult. Although evidenced-based clinical practice guidelines exist to direct the management of pain in the older adult, health care providers are either unaware or lack the proper understanding of the guidelines. This study investigated the differences in knowledge of pain management in older adults when examining licensed acute care nurses and extended care nurses. It sampled 118 acute care nurses working in two hospitals in Mississippi and 78 extended care nurses working in six extended care facilities (ECF) in Mississippi.

Based upon the …

Living With Alzheimer’S Disease: A Study Of Adult Day Health Services In Massachusetts, Nina M. Silverstein, Cathy M. Wong, Kristen E. Brueck

Gerontology Institute Publications

The role of adult day health care (ADHC) is gaining increased attention as the nation prepares for the large cohort of baby boomers entering their later years. Many boomers are aging with physical and cognitive impairments, including Alzheimer's disease and related dementias. Projections indicate that Massachusetts, along with the nation as a whole, is experiencing an increasing rate of older persons as baby boomers enter late-life. The Commonwealth can expect that persons with Alzheimer's disease and their care partners will need community-based services that are specifically designed for adults with cognitive impairments. However, a report by the Robert Wood Johnson …

Caring For America’S Aging Population: A Profile Of The Direct-Care Workforce, Kristin E. Smith, Reagan A. Baughman

Sociology

Direct-care workers constitute a low-wage, high-turnover workforce with low levels of health insurance; taking these characteristics into account guides the challenge of how to deal with the growing demand for long-term care by an aging U.S. population.

Relationship Between Functional Level And Cost Of Care Of Nursing Home Residents As Measured By The Functional Component Of The Minimum Data Set And The Breines Functional Assessment Scale, Jeanne Turnamian

Seton Hall University Dissertations and Theses (ETDs)

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Fall Risk Assessment : A Prospective Investigation Of Nurses' Clinical Judgement And Risk Assessment Tools In Predicting Patient Falls In An Acute Care Setting, Helen Myers

Theses: Doctorates and Masters

Falls are a significant problem in acute care, hospital settings, and can have serious consequences, especially for older patients. Fall prevention has therefore been recognised as an important area for research and intervention. In order to target interventions and use resources effectively, a major strategy of many fall prevention programmes has been the development and/or use of risk assessment tools to identify patients who are at high risk of falling. Although many tools have been developed, few have been rigorously tested, and there is currently no evidence to support the clinical utility of fall risk assessment tools. There is a …

Transportation: A Crucial Issue For Adult Day Care In Vermont, Francis G. Caro, Regula H. Robnett, Jennifer Higgins

Gerontology Institute Publications

Transportation arrangements are an integral but fragile element in the effectiveness of adult day care services in Vermont and nationwide. Almost by definition, adult day center participants generally cannot drive due to cognitive and/or physical limitations. Since adult day care services are congregate in nature and serve community-residing elders, this long-term care option is feasible only when there are arrangements to transport elders to and from service centers. Transportation is therefore a major issue for adult day care services.

The aim of this report is to call attention to transportation issues in adult day care services in Vermont. The report …

Update - December 1999, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- John and Alice Wong establish bioethics endowment
-- Richard Rice receives Templeton Award
-- "Humans" and "Persons" in Christian Bioethics (Commentary)
-- Mechanically Restraining the Ill and Elderly: Ethical Problems and Proposals
-- Clinical Ethics Consultation
-- Learn to minister in the clinical setting

Sensitizing Students To Functional Limitations In The Elderly: An Aging Simulation, Sherry Allen, Viki Lorraine, Anne Lockett, Carolyn M. Rutledge

Ellmer School of Nursing Faculty Publications

Background and Objectives: Using activities of daily living (ADLs) and instrumental activities of daily living (IADLs) as a focus, faculty at Eastern Virginia Medical School provide an aging simulation exercise for a mandatory fouth-year clerkship in geriatrics. The specific aims of the simulation are to 1) experience the physical frailties of aging, 2) develop creative problem-solving techniques, 3) identify feelings regarding the experience of functional loss, and 4) develop proactive clinical approaches to the care of the elderly.

Methods: Students are assigned one of four diagnoses (Parkinson's disease, rheumatoid arthritis, advanced diabetes, or stroke) and are then impaired to simulate …

Book Review, Mitchell M. Simon

RISK: Health, Safety & Environment (1990-2002)

Review of: MARSHALL A. KAPP, ETHICAL ASPECTS OF HEALTH CARE FOR THE ELDERLY: AN ANNOTATED BIBLIOGRAPHY. (Greenwood Press 1992). [200 pp.] Number 17 in series, Bibliographies and Indices in Gerontology. Author index; foreword by Erdman B. Palmore, series editor; preface; subject index. LC: 92-17776; ISBN: 0-313-27490-8. [Cloth $45.00. P.O. Box 5007, Westport CT 06881.]

Abuse, Neglect And Exploitation In Licensed Facilities - Recognize It - Prevent It - Report It, Maine Department Of Human Services

Maine Collection

Abuse, Neglect and Exploitation In Licensed Facilities - Recognize It - Prevent It - Report It.

Maine Department of Human Services - Bureau of Elder and Adult Services, Augusta, Maine (August 1993).

Contents: Introduction / Signs of Abuse and Neglect / Abuse: Risk Factors / Prevention / Maine's Reporting Law / Investigations of Reports of Abuse, Neglect or Exploitation / Where to Report / Other Relevant Agencies

How Registered Nurses In Skilled Nursing Facilities Rate The Importance Of And The Frequency Engaged In Specific Nursing Behaviors Related To Their Role, Christine Anne Heine

Ellmer School of Nursing Theses & Dissertations

Registered nurses in skilled nursing facilities were surveyed using the Six-Dimension Scale of Nursing Performance to determine: (1) how they rated the importance of specific nursing behaviors related to their role, (2) how they rated the frequency engaged in the same specific nursing behaviors related to their role, and (3) if there was a relationship between how they rated the specific nursing behaviors for importance and frequency. There were five subgroups of nursing behaviors: (a) leadership, (b) nursing process, (c) teaching and collaboration, (d) interpersonal relations and communication, and (e) professional development. Registered nurses rated all of the behaviors as …