Geriatric Nursing Commons^™

Evaluation Of A Care Management Program On Family Caregivers Of Persons With Dementia, Victoria L. Jackson

Doctoral Projects

Dementia due to Alzheimer’s and other disease is a growing concern for healthcare providers as the number of individuals in the U.S. population ages. Persons with dementia (PWDs) rely on caregivers, primarily family caregivers (FCGs), for basic and instrumental activities of daily living as the disease progresses. There may be negative outcomes, such as depression, strain, and distress for FCGs of PWDs. Routine assessment and intervention by healthcare providers can address needs of FCGs of PWDs. There are multiple interventions that have demonstrated effectiveness in caring for PWDs and FCGs; one such intervention is care management. The University of California, …

Therapeutic Gardening And Its Effects On Depressive Symptoms In Dementia Care, Shannon E. Norton

Honors Undergraduate Theses

Aim: To present a literature review of the positive effects and overall reduction of depressive symptoms that an intervention such as therapeutic gardening has on individuals living within memory care facilities.

Background: As most humans age, they often lose abilities or skills that they have had for their entire lives (e.g. driving, grooming, toileting, seeing and/or hearing). By implementing programs that involve therapeutic garden therapy, individuals with dementia who are at greater risk for clinical depressive symptoms may find that this alternative approach improves their symptoms.

Methods: A comprehensive, electronic, literature search in the CINAHL database was completed and included …

Improving Nursing Staff Knowledge For Management Of Geriatric Patients With Confusion In The Emergency Department, Kareem G. Carter

Master's Projects and Capstones

Problem: Staff knowledge of effective management of confusion in geriatric patients (>65yo) may be limited and inconsistent with the current goal of establishing a geriatric-friendly Emergency Department (ED) Model of Care. Suboptimal management of this patient population can result in prolonged ED stays, which increases the cost to the hospital and the patient (Han & Wilber, 2013).

Context: An Emergency Department at a large Bay Area urban hospital hopes to obtain Geriatric Emergency Department Accreditation (GEDA) through the American College of Emergency Physicians (ACEP).

Interventions: Create a simplified checklist for nursing staff using mnemonic devices to …

Impact Of Montessori-Based Dementia Programming On Engagement And Affect Of Older Adults With Dementia, Meredith S. Sheppard

Master's Projects and Capstones

The COVID-19 pandemic has profoundly impacted the Adult Day Services program and Adult Day programs across the country. As the Adult Day Services program transitions to an in-person format, goals within the organization include developing appropriate programming, increasing group size, and keeping clients entertained. The framework guiding this quality improvement project is Montessori-Based Dementia Programming ® (MBDP). This project aims to increase client engagement, decrease client anxiety, and decrease staff workload. This will be measured by a self-developed staff workload survey, the Menorah-Park Engagement, and the Affect rating scale. Implementation of MBDP at the Adult Day Center did not meet …

The Lived Experience Of Losing Employment After Diagnosis With Dementia: A Phenomenological Analysis, Susan K. Blaine

Doctoral Dissertations

The purpose of this study was describing the experiences of people with dementia (PWD) who lose their employment after diagnosis with dementia, but sooner than originally planned. A phenomenological approach based on tenets of Maurice Merleau-Ponty was used. Six telephone interviews were conducted, with participants sharing their experiences. Transcripts were transcribed verbatim, and subsequently analyzed via a hermeneutical analysis approach. Themes were identified within and between transcripts, considering the contextual grounds of Merleau-Ponty’s phenomenology: body, others, time, and world, and the contextual ground of participants’ experience: the stigma of dementia. An overarching, central theme of “still working” was identified across …

Palliative Care Screening For Persons Living With Dementia In A Nursing Home, Shanika S. Pruitt

Dissertations

Problem: Dementia is rapidly increasing as the people of the world mature and life expectancy increases. As the world ages and the prevalence of dementia increases, nursing home placement will and is the most sought place for care of this population. Dementia is under recognized as a terminal illness and palliative care is underutilized for nursing home residents with advanced symptoms of dementia.

Methods: This quality improvement (QI) initiative utilized a prospective, descriptive design. The Palliative Care Screening for the Elderly tool was administered to a purposive sample of persons living with dementia residing in the nursing home. Qualitative data …

The Psychosocial Experiences Of African American Sexual And Gender Minority Caregivers Of People With Dementia, Lakeva Harris

Doctoral Dissertations

Over 50 million people in the United States provide unpaid care to a family member or friend. One-third of these caregivers (16 million) provide care to someone with Alzheimer’s disease and related dementias (ADRD). Of these caregivers, more than 20% state caregiving has led to a decline in their health. African American caregivers are less likely to report being in very good or better health than their white caregiving peers. Similarly, lesbian, gay, bisexual, transgender, and/or queer (LGBTQ) caregivers are more likely to report fair or poor health than their heterosexual, cisgender peers. The overlap of these minoritized identities may …

Evidence-Based Recommendations For Assistive Technologies For Safety In Dementia Care, Lee A. Diener

Culminating Experience Projects

A Quality Improvement (QI) project in a Midwestern Continuing Care Residential Community (CCRC) was designed to examine the evidence-base of four assistive technology platforms marketed as safety platforms as means to improve outcomes for older adults residing in memory care environments. Using the Evidence-Based Design Model Socio-Technical Systems Theory, survey data and observational data collected from the organization were considered with respect to the evidence-base supporting each technology. Ten organizational priorities derived from collected data were used to develop an Evidence-Based Assistive Technology Fitness score for each of the AT platforms reviewed. This methodology provides a means to evaluate planning …

Improving Cognitive Function In Persons With Dementia Through Music Therapy, Jillian Natividad

Nursing | Senior Theses

People diagnosed with dementia experience cognitive alterations that cause overwhelming challenges and lead to distinctive life changes. Declining cognitive function noticeably experienced in dementia not only inflicts difficulty with achieving independent living but increases feelings of agitation and disturbs quality of life. Advanced medical care is widely available for managing mental conditions but may not always be effective in treating cognitive changes like memory loss and confusion. Because the stages of dementia vary from person to person, medical interventions are often patient centered to effectively focus on an individual’s specific needs. With non-pharmacological methods, flexibility in adjusting to an individual’s …

Do Young Adults With Close Family Experiencing Alzheimer's Have Higher Depression Rates, Ali Sullivan

Chancellor’s Honors Program Projects

No abstract provided.

Life Satisfaction: Aging Female Informal Caregivers Of Persons With Dementia, Deborah Ann Monson

Dissertations

Purpose/Aims

The purpose of this study was to describe the relationship between aging female informal caregivers of persons with dementia (PWD) and care recipients’ PWD demographic factors, aging female informal caregivers of PWD social support factors, positive and negative feelings, a sense of flourishing, stress, and life satisfaction.

Background/Rationale

Older adults with dementia are living longer and the majority are receiving care by aging female informal caregivers. Dementia incrementally worsens over time impacting informal caregiver life satisfaction. Most studies have focused on negative aspects of informal caregiving. Therefore, this study investigated both positive and negative aspects of caregiving.

Conceptual Basis …

How Providing Care For Individuals With Dementia Affects How A Caregiver Changes Their Lifestyle: A Focus On The Positives, Veronica Joy Vodola

Senior Theses

Background/significance Caregivers of individuals with dementia (e.g. Alzheimer’s Disease) may change their day-to-day life, especially self-care, to meet the needs of the person with dementia, which can be detrimental to their health. Caregivers for individuals with dementia experience both primarily negative and primarily positive effects on physical and mental health through exposure to the effects of dementia. Caregivers often report substandard self-care practices and unpleasant impacts on mental health. Others report notable beneficial influences within different aspects of their life. The positive effects have not been widely researched in literature.

Purpose The objective of this research study is to understand …

Improving Caregivers’ Perceived Involvement In Care Through Facilitating Communication With Hospital Providers, Heather Manolas

Student Scholarly Projects

Practice Problem: Involvement of family in care-planning for prevention of delirium in acute care settings is crucial, yet remains underutilized in those who are cognitively impaired. Despite the incidence of delirium in acute care worsening during COVID-19, many factors have led to it being placed on the back burner.

PICOT: In caregivers of cognitively impaired individuals, can implementation of an evidence-based, best practice tool that advocates for evidence-based delirium prevention strategies tailored to their loved-one and facilitates family involvement in care planning for these strategies during a healthcare experience as compared to no other intervention improve confidence in, and …

Implementation Of Cognitive Testing Via Video-Telemedicine, Lindsay Mills Holland, Rosemary Dale, Mary Val Palumbo

College of Nursing and Health Sciences Doctor of Nursing Practice (DNP) Project Publications

Background: Early diagnosis and timely follow-up of cognitive decline are essential to preserve individual function and memory, improve quality of life, and decrease healthcare costs. Many barriers to in-person assessment exist, the most recent one being COVID-19. Video-telemedicine has been studied as a solution with promising results. Most notably, research shows that the Mini Mental State Examination (MMSE) administered via video-telemedicine has comparable results to in-person assessment.

Purpose: The purpose of this project was to implement cognitive testing via video-telemedicine for follow-up management of cognitive impairment and dementia.

Methods: A protocol for conducting the MMSE via Zoom was developed. Next, …

Fall Risk Factors Among Hospitalized Older Adults With Alzheimer’S Disease And Related Dementias, Jean Bettencourtt Sconza

Doctoral Dissertations

Falls are a common and devastating complication of hospital admission for older adults. Falls are especially significant for those with Alzheimer’s Disease and related dementias (ADRD) as they are at high risk to fall and to suffer injuries from falling. Despite the large body of research on falls in hospitals, less is known about fall risk factors among patients with ADRD. The purpose of this retrospective case-control study was to determine which risk factors are predictors of falls among hospitalized older adults with Alzheimer’s disease and related dementias (ADRD) by comparing those who fell with those who did not fall. …

Barriers To Patient-Centered Care For Dementia Clients In The Long-Term Living Setting, Shaina Gaba

Nursing | Senior Theses

When caring for people with severe dementia, the concept of the person being central is increasingly advocated in clinical practice. Person-centered care acknowledges autonomy in all facets of care. Recent studies examine behavioral changes in individuals with dementia and how health care teams address these alterations. Health care providers are vital for effective holistic management. Therefore, this review focuses on the current knowledge regarding care goals, practices, and perceptions of the client battling with cognitive decline. A literature review ascertains that clients with dementia respond to interventions and have decreased negative health outcomes, when providers ensure values and needs are …

Engaging Patients With Dementia In The Acute Care Setting: A Quality Improvement Initiative For Staff, Andrea Lee

DNP Scholarly Projects

Caring for dementia patients in the acute care setting can be challenging. Staff is trained to manage the acute illness and the symptoms of dementia can impact that care. Training for the care and management of the patient with dementia is not routinely provided for the acute care setting. According to the Alzheimer’s Association (2018), 5.7 million people are living with Alzheimer’s Dementia with the numbers projected to continue to rise. Training in the management of symptoms can alleviate stress and complications for not only the patient but staff members as well. The goal of this project is to educate …

The Effects Of A Dementia Simulation Experience On Attitudes Towards People With Dementia, Micah Huckabee

Health, Human Performance and Recreation Undergraduate Honors Theses

Introduction: The neurodegenerative effects of dementia resulting in cognitive and behavioral impairments is plausibly one of the reasons for a societal stigma towards individuals with dementia. Societal stigmas are associated with decreased life satisfaction, depressive symptoms, and decreased psychological well-being for stigmatized individuals. In an effort to improve attitudes towards individuals with dementia, this study utilized a dementia simulation to measure attitudinal changes after a dementia simulation. Methods: There were 33 participants in this study (13 male and 20 female) between the ages of 18 and 25. Participants completed a Dementia Attitudes Scale (DAS) survey, and then they dressed in …

Implementation Of An Evidence Based Screening Protocol To Improve The Diagnosis Of Dementia In A Home-Based Primary Care Setting, Lauren Liesbeth Sutton

Doctoral Projects

Dementia is a major public health concern that is both debilitating and deleterious to those afflicted with its various forms. The number of those living with dementia is increasing exponentially as the population continues to rise, with 46.8 million people worldwide currently afflicted with dementia (Chow et al., 2018). Dementia causes cognitive impairment that is severe enough to affect everyday function (Chow et al., 2018). The impairment and disability resulting from dementia indicates a significant health problem in primary care. Findings from research studies indicate that prophylactic and periodic screening for dementia can heighten provider suspicion and translate into earlier …

Caregiver Outcomes Of A Dementia Care Program, Leslie Chang Evertson

Doctoral Projects

The University of California, Los Angeles Alzheimer’s and Dementia Care (ADC) program enrolls people with dementia (PWD) and their family caregivers as dyads to work with nurse practitioner dementia care specialists to provide coordinated dementia care. At one year, despite disease progression, the PWDs’ behavioral and depressive symptoms improved. In addition, at one-year, caregiver depression, distress related to behavioral symptoms, and caregiver strain also improved. Not all dyads enrolled in the ADC program appear to experience benefit. Although strain and distress remained stable or decreased for the majority of caregivers, a portion reported an increase in both. Semi-structured interviewed were …

The Lived Experience Of Spiritual Well-Being Amongst Informal Caregivers Of Persons With Dementia On Palliative Care Living At Home, Michael Baumgardner

Dissertations

Title. The Lived Experience of Spiritual Well-Being Amongst Informal Caregivers of Persons with Dementia on Palliative Care Living at Home.

Purpose.This study explored the lived experience of spiritual well-being amongst informal caregivers of a person with dementia who were living at home and enrolled in palliative care.

Background. Patients with dementia comprise the third leading diagnosis in palliative care patients and many receive informal care from family members. Palliative care improves quality of life in patients and their informal caregivers. However, little is known about spiritual well-being in the setting of caregiving of persons with dementia on palliative care. …

Interlace: Designing An Inclusionary Architecture For Alzheimer's Sufferers, Alexander Fashinasi

Bachelor of Architecture Theses - 5th Year

This thesis intends to address the increasing challenges the Alzheimer’s disease poses for our growing American population. The research begins by looking at the brain as a combination of components which make up the individual. Following this, the research compiles information on the Alzheimer’s disease and its symptoms, followed by an analysis of the built environments effects on the condition.

Through analysis of precedent cases and the combined Alzheimer’s research, I chose to propose an experimental community in which those with Alzheimer’s can live a life with greater autonomy while simultaneously slowing the progression of the disease. I place this …

Evaluating The Effectiveness Of A Formal Dementia Care Training Program: Abilities Care Experts™, Carmen Joaquin, Michelle D'Amato, April Perez, Louiza Alexandria Villarina, Sophie E. Miller

Dissertations, Masters Theses, Capstones, and Culminating Projects

Overview: Abilities Care Experts™ (ACE™) is an educational training program for nursing staff who care for individuals with dementia in skilled nursing facilities (SNF). The objective of the program is to provide the nursing staff with knowledge, and methods to engage residents’ remaining abilities in order to maximize occupational participation using a stage-specific dementia care approach. ACE™ training has yet to be evaluated for effectiveness in a controlled study design.

Objectives: This study sought to evaluate the effectiveness of the ACE™ training.

Design: The study employed a quantitative, cross-sectional, quasi-experimental design.

Participants: A total of 29 CNAs, 13 ACE™ trained …

An Exploration Of Dementia Friendly Communities From The Perspective Of Persons Living With Dementia, Catherine Hebert

Electronic Theses and Dissertations

The growing global prevalence of dementia coupled with a shift in public perception from a hopeless disease to the possibility of living well with dementia has led to the formation of dementia friendly communities (DFC). DFCs are a new phenomenon in the United States, with a gap in knowledge on input from people living with dementia (PLWD). This study investigated DFCs from the perspective of PLWD in Western North Carolina, with the following research questions:

1. How are interactions and relationships experienced by persons living with dementia in the community?
2. How is community engagement experienced by PLWD?
3. To what extent and …

Alzheimer's Disease, Kirstin Fortune

Nursing Student Class Projects (Formerly MSN)

This presentation is an overview on Alzheimer's disease. Signs, symptoms, pathophysiology and pharmaceuticals are all incorporated in this poster. The United States is planning to address the possible crisis of Alzheimer's with many initiatives.

Linking Key Factors Of Quality Dementia Care: Knowledge And Self-Efficacy, Sophie E. Miller

Honors Theses

Dementia-related changes in cognition, memory, and personality can have wide-ranging impacts on individuals, families, and healthcare systems (Plassman et al., 2007); including caregiver burnout, disruption of family life, and costly care requirements (Graneheim, Johansson, & Lindgren, 2014). Dementia has become a global issue; 46 million people worldwide have dementia and $600 billion are spent on dementia-related care every year (Farina al., 2016). Certified nursing assistants (CNAs) generally assume the majority of day-to-day care and are a vital component of providing quality, person-centered services to patients with dementia in residential care (Burke & Orlowski, 2015). The purpose of this study was …

Communicative Behaviors Elicited By Leisure Activities In Memory Care Units, Tarynn Clune

Honors Projects

A wide variety of leisure activities used in reminiscence care have been studied for their merits in terms of preventing cognitive decline, and increasing quality of life; however, little is known about what different types have to offer in terms of communicative opportunities. Communication with peers is imperative for quality of life, and is crucial for maintenance of relationships between the person with dementia (PWD) and their loved ones. As a result of this importance, an exploration of communication elicited by different activities facilitated in a unit was conducted. The communication explored in this study was solely vocal, and included …

The Use Of Herbal Supplements On Minimizing The Clinical Manifestations Of Alzheimer's Disease, Delayna L. Donohue

Honors Undergraduate Theses

Alzheimer’s disease (AD) affects over 5 million individuals in the United States annually. By the year 2050, the number of individuals living with AD is projected to triple (Latest Alzheimer’s Facts and Figures, 2016). Although there is no cure for AD, there are many prescriptive pharmacologic agents used to help manage the clinical manifestations of the disease. Complementary and alternative medicines (CAM) and herbal supplements are also used in the treatment of AD, however indications for their use and effectiveness during the progression of AD have not been examined. The purpose of this study was to examine the use of …

A Resident-Centered Dementia Care Staff Education Project To Reduce Challenging Behaviors At A Long-Term Care Facility, Margaret Huryk

Seton Hall University DNP Final Projects

Frequent use of antipsychotic medication (APM) for behavioral and psychological symptoms of dementia (BPSD) persists at high levels in long- term care (LTC) facilities despite extensive evidence of modest clinical benefits, serious adverse effects, public health advisories and a national initiative to improve dementia care. There is a gap between best-practice evidence and actual clinical practice related to pharmacological and nonpharmacological care for persons with dementia (PWD) and BPSD and/or neuropsychiatric symptoms (NPS) of dementia. The literature shows that clinicians often ignore FDA (Food and Drug Administration) warnings, CMS (the Centers for Medicare and Medicaid Services) initiatives and expert opinion …

Barriers To Music Therapy In The Care Of Those With Alzheimer's/Dementia, Karin E. Kvam

Honors College Theses

This pilot study examines the barriers caregivers encounter when implementing music therapy in the care of those with Alzheimer’s/dementia. An 8-question survey was distributed at two long-term care facilities and an Alzheimer’s support group to understand how often and in what ways music therapy is utilized, as well as what barriers caregivers face when using the therapy. Results indicated that, although the majority of caregivers report using music therapy, it is not implemented as frequently as it could or should be. Caregivers report a knowledge deficit as the main reason for not implementing music therapy. The data suggests that an …