Geriatric Nursing Commons^™

Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota For State Policymakers, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. State governments design their methods of reimbursing nursing homes to achieve desired policy objectives related to facility cost and quality, access to care, payment equity, service capacity, and budgetary control.

Often, participation in the process of developing Medicaid payment policy is limited to state agency officials and providers of care and, occasionally, union representatives and state legislative staff. Invited less frequently to reimbursement policy discussions are consumer representatives. Lack of consumer involvement in the development of state rate setting systems has the potential to result in the …

A Primer For Consumer Involvement In Medicaid Nursing Facility Reimbursement: Lessons From New York And Minnesota, Edward Alan Miller, Cynthia Rudder

Gerontology Institute Publications

Medicaid is the major purchaser of nursing home care in the United States. To ensure that providers behave appropriately, the federal and state governments have established an extensive set of regulations that nursing homes must comply with if they are to be reimbursed for patients insured by Medicaid. Consumers exert considerable influence here by focusing on regulations and enforcement of non-compliance.

States also seek to align providers’ interests with those of other interested parties through controls and incentives built into state reimbursement systems, including with respect to facility cost and quality, access to care, payment equity, service capacity, and budgetary …

Identifying And Managing Caregiver Burden Among Spouses Of Individuals With Parkinson's Disease, Kaitlyn Roland, Andrew Johnson, Mary Jenkins

Andrew M. Johnson

Burden is a psychological concept, a subjective interpretation by caregivers of the extent to which the caregiving experience impacts on one's health, social life, or financial status. In this article, we examine some of the predictors of caregiver burden, and look specifically at the burden experienced by caregivers of individuals with Parkinson's disease.

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

Nina Silverstein

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 …

Feasibility And Impact Of Telemonitor-Based Depression Care Management For Geriatric Homecare Patients, Thomas Sheeran, Terry Rabinowitz, Jennifer Lotterman, Catherine F. Reilly, Suzanne Brown Rn, Patricia Donehower, Elizabeth Ellsworth, Judith L. Amour, Martha L. Bruce

Social Work Faculty Publications

Objective: The objective of this study was to test the feasibility, acceptability, and preliminary clinical outcomes of a method to leverage existing home healthcare telemonitoring technology to deliver depression care management (DCM) to both Spanish- and English-speaking elderly homebound recipients of homecare services.

Materials and Methods: Three stand-alone, nonprofit community homecare agencies located in New York, Vermont, and Miami participated in this study. Evidence-based DCM was adapted to the telemonitor platform by programming questions and educational information on depression symptoms, antidepressant adherence, and side effects. Recruited patients participated for a minimum of 3 weeks. Telehealth nurses were trained on DCM …

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, …

Information Placed In Trust: Older Gay Men And Social Workers On Talking About Sexual Identity In Aged Care, Mark Hughes

Professor Mark Hughes

As more men who openly identify as gay approach older age, it is important for health and aged care professionals to consider the appropriateness of talking with these men about their sexual identity. This paper reports findings from a pilot study that examined how sexual identity should be acknowledged in aged care practice. The paper draws on qualitative data from two focus groups; one with older gay men and one with social workers. An analysis of the themes that overlapped the two groups highlighted the extent to which participants thought sexual identity should be discussed openly, the value placed on …

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 Relationship Of Financial Performance, Quality Indicators, And The Role Of Nurse Executives In Virginia Nursing Homes, Jeany V. Murphy

Health Services Research Dissertations

Problem statement. The dynamic nature of the healthcare industry has triggered changes in nurse executive functions. The job has expanded into entrepreneurial roles to be able to provide the most cost effective services while maintaining good quality outcomes for the residents. The new responsibility requires a different set of knowledge and competencies that is usually achieved through advanced education. It is not known whether nurse executives in long term care in Virginia possess the skills to influence both the financial and quality outcomes of the facility.

Methods. This descriptive research study examined the relationship of the nurse executives' technical, human, …

Planned Cesarean Delivery And Urinary Retention Associated With Spinal Morphine, Susan M. Diblasi

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Cesarean delivery (CD) is the second most commonly performed surgery in the United States. As such, prevention of complications associated with this procedure is a top priority in nursing care. Nurses at the study insti- tution perceived that postcesarean patients experienced increased uri- nary retention after use of spinal morphine for postoperative pain relief. This observation prompted a review of the literature indicating that limited research had been conducted in this area. The purpose of this study was to explore the relationship of postelective CD urinary reten- tion and dose of spinal morphine. A retrospective, quasi-experimental, three-group design was used. …

Long-Term Care, Emma Kontzamanis, Keville Frederickson

Publications and Research

In chis chapter, the need for long-term care services is explained from the perspective of the explosive growth of the older population as well as the increase in disability and chronic illness in the general population. A definition of long-term care within the contexts of inpatient and community-based services is also explained. In the United States the focus of long-term care is on nursing homes. This will be discussed as well as alternatives co nursing home care which involve integrated services such as case management, social health maintenance organizations, and programs of all inclusive care for elders. Solutions to the …

Artificial Nutrition, Advance Directives And End Of Life In Nursing Homes, Cheryl Ann Monturo

Nursing Faculty Publications

No abstract provided.

A New Look At Successful Aging : Exploring A Mid-Range Nursing Theory Among Older Adults In A Low-Income Retirement Community., Valerie Lander Mccarthy

Faculty Scholarship

The current view of successful aging excludes elders with disease or disability, limits the potential for success among disadvantaged populations, and fails to consider older adults’ own criteria for success, especially in the existential or spiritual domain. This cross-sectional study was a preliminary investigation of a mid-range nursing theory (Flood, 2005) of successful aging. A random, stratified sample (N= 112) was used. Questionnaires were administered to small groups of non-demented older adults. Relationships among study variables were examined using hierarchical multiple regression. Adaptation and transcendence explained 45.4% of the variance in successful aging, independent of age, income, function, and health. …

Does An Online Computer Based Critical Care Orientation Program Support The Learning Needs Of A Multigenerational Workforce?, Patricia Brady

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The complexities of today's health care system challenge acute care hospitals to provide comprehensive nursing orientation programs while meeting the needs of a multigenerational workforce. To prepare nurses to provide the highest quality of care for patients, nursing orientation must provide updated content, be cost effective, time sensitive and comprehensive, stimulate critical thinking skills, and include relevant evidence-based knowledge. Although a comprehensive nursing orientation is essential to every area of practice, specialties, such as critical care nursing, require specialized knowledge and additional skill sets that necessitate a more comprehensive training program while being sensitive to the needs of a multigenerational …

Inside The Mind Of A Rapid Response Activator, Gail Maureen Mosher

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

The health care delivery system in this nation continues to spiral out of control. Statistics report on the shocking number of people who are harmed or die due to medical errors. This project will focus on one process in the armamentarium, the Rapid Response Team (RRT). The purpose of the study was to explore staff nurse perceived barriers and enhancers to an effective RRT. Qualitative design was employed and individual semi-structured interviews were conducted at a 359 bed community hospital. The sample consisted of 15 medical-surgical nurses who had experienced a rapid response (RR) event at this site. Potential subjects …

Development And Implementation Of A Certified Neuroscience Registered Nurse Exam Review Program, Joan M. Walsh

Master's Theses, Dissertations, Graduate Research and Major Papers Overview

Rhode Island Hospital (RIH) is currently striving to attain Magnet® status; specialty certification of registered nurse (RN) staff plays an important role in achieving that goal. Unit based nursing leadership and RN staff identified neuroscience certification as both important and desirable. One of the barriers identified by the staff RNs was the lack of a study support program to assist in preparation for the certification exam. A certified neuroscience registered nurse (CNRN) exam review program motivates and supports the RN staff to seek certification and successfully sit for the exam. The primary purpose of this program was to increase the …

An Evaluation Of The Effectiveness Of Tailored Smoking-Cessation Training For Health And Social Care Professionals Who Work With Older People, S Kerr, R Whyte, H Watson, Debbie Tolson, A Mcfadyen

Professor Debbie Tolson

In press

The Prevalence Of Healthcare Associated Infection In Older People In Acute Hospitals, S Cairns, J Reilly, S Stewart, Debbie Tolson, J Godwin, P Knight

Professor Debbie Tolson

In press

Medical Care In The Nursing Home, Debbie Tolson, J Morley

Professor Debbie Tolson

No abstract provided.

Using The Research Process To Develop Group Services For Older Persons With A Hearing Disabilit, T Kelly, Debbie Tolson, T Day-Smith, G Mccolgan, W Maclaren

Professor Debbie Tolson

No abstract provided.

Advanced Practice Nurses And Attending Physicians: A Collaboration To Improve Quality Of Care In The Nursing Home, C Philpot, Debbie Tolson, J Morley

Professor Debbie Tolson

No abstract provided.