Geriatric Nursing Commons^™

Are Informal Carers And Community Care Workers Effective In Managing Malnutrition In The Older Adult Community? A Systematic Review Of Current Evidence, Skye Marshall, Judith Bauer, Sandra Capra, Elisabeth Isenring

Skye Marshall

International Health Care Issues And Services Identified While Mapping The Gerontological Nursing Literature, Marcia Henry, Marilia Antunez, Dorice Vieira, Kent Randell

Marilia Y. Antúnez

Bibliometric analysis of cited references; analyzed keywords, subject content, and authors to discern global issues of aging and collaborations of the articles published in three leading gerontological journals from 2008-2010.

Effects Of Calming Music On Agitation In Nursing Home Residents, Patricia Tabloski, Ruth Remington, Leah Mckinnon-Howe

Ruth Remington

This article examines the use of calming music to decrease agitation in cognitively impaired nursing home residents. Calming music has been shown to be an effective, nonpharmacologic strategy to reduce agitated behavior in persons with dementia.

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 …

Efficacy Of A Vitamin/Nutriceutical Formulation For Early-Stage Alzheimer’S Disease: A One-Year, Open-Label Pilot Study With An 11-Month Caregiver Extension, A Chan, J Paskavitz, Ruth Remington, S Rasmussen, Thomas Shea

Ruth Remington

No abstract provided.

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 …

Optimizing Functionality Of Clients With Age-Related Macular Degeneration, Arlene Mcgrory, Ruth Remington

Ruth Remington

Age-related macular degeneration (ARMD) is a major cause of severe vision loss and blindness among older people. This condition is progressive, incurable, and significantly compromises central vision. Rehabilitation nurses have a pivotal role in the assessment and management of clients with ARMD. An understanding of incidence and pathophysiology of ARMD, as well as health promotion and a new treatment for ARMD can help rehabilitation nurses design interventions to help clients maintain an acceptable quality of life despite declining vision.

Neuroprotective Effects Of Apples On Cognition And Alzheimer’S Disease, Ruth Remington, A Chan, F Tchantchou, D Ortiz, Thomas Shea

Ruth Remington

Consumption of apples is known to reduce risk of some cancers, cardiovascular disease, asthma, and diabetes. Studies over the last decade reviewed herein, demonstrate that apples also provide neuroprotection, to the extent that they can impact hallmarks and some symptoms of Alzheimer’s disease (AD).

Evidence-Based Guideline: Wandering, May Futrell, Karen Melillo, Ruth Remington

Ruth Remington

No abstract provided.

Effects Of Calming Music On The Level Of Agitation In Cognitively Impaired Nursing Home Residents, Patricia Tabloski, Leah Mckinnon-Howe, Ruth Remington

Ruth Remington

This study examines the use of music as a strategy to decrease agitated behavior in cognitively impaired nursing home residents. Twenty agitated subjects, 68 to 84 years of age, were exposed to 15 minutes of calming music on two occasions. Agitated behavior scores were recorded before, during and after the musical intervention using the Agitated Behavior Scale. Results indicate that a statistically significant reduction in agitated behavior occurs both during (p.

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 …

Using Antipsychotic Drugs Safely In Older Patients, Lisa Abdallah, Jane Flanagan, Karen Melillo, Ruth Remington

Ruth Remington

Do you know how to monitor an older adult who's receiving an antipsychotic drug? Learn the benefits and the pitfalls so you can keep your older patients safe

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.

Alzheimer’S Disease: Are We Intervening Too Late? Yes, By Years If Not Decades, Thomas Shea, Ruth Remington

Ruth Remington

The ongoing debate as to whether we are or are not early enough in treatment for Alzheimer's disease presents distinct vantage points. Points expressed range from stressing the need for early preventive measures to highlighting the failure of "alternative" therapies, and concluding that we are unfortunately doing all that we can at present. Herein, we stress the worth of nutritional intervention, and review why such studies are often inherently compromised. We conclude that considerable education is needed to advance lifestyle modifications early enough to obtain their optimal effect, and instead of positioning "classical" interventions against "alternative" interventions, the combinations of …

Nutrition And Dementia: Are We Asking The Right Questions?, Thomas Shea, E Rogers, Ruth Remington

Ruth Remington

Alzheimer's disease (AD) has no cure or nullifying pharmacological interventions. Nutritional supplementation represents a systemic approach that in some studies has provided benefit and has augmented pharmacological approaches. However, additional studies report no benefit of supplementation. We review herein how studies of nutrition on dementia, including those combining nutrition and dementia, are inherently compromised. We also review studies with mice, which demonstrate that nutritional supplementation can alleviate multiple genetic risk factors for AD. An individual diagnosed with AD has by definition undergone considerable cognitive decline; anticipating restoration/maintenance of cognitive performance following nutritional supplementation alone may be misdirected. Nutrition declines in …

A Comparison Of Hospice In The Us And Uk: Implications For Policy And Practice, Ruth Remington, G Wakim

Ruth Remington

The modern hospice movement in the United States was modeled on the specialized care for dying individuals that was championed by Dame Cicely Saunders, a social worker, nurse, and physician, in London in the 1960s. A collaboration between Saunders and Florence Wald, then at Yale University, led to the establishment of the first hospice in the United States in 1974. Despite similar foundations, the provision of hospice care differs in the United States and the United Kingdom with regard to financing and access. This article reviews these similarities and differences and discusses implications for U.S. hospice policy.

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 …

Hypodermoclysis To Treat Dehydration: A Review Of The Evidence, Ruth Remington, Todd Hultman

Ruth Remington

Dehydration is a serious acute condition in older adults associated with significant morbidity and mortality. Hypodermoclysis (HDC; the infusion of fluids into the subcutaneous tissue) can provide an alternative to intravenous (IV) rehydration of older adults. This article reviews the relevant literature on the use of HDC to treat mild to moderate dehydration in older adults. A comprehensive search of the literature was conducted to identify research reports on the use of HDC to treat dehydration in older adults. Articles published in English during the previous 10 years were reviewed to reflect current standards of practice. One systematic review; two …

Implications Of Differential Impacts Of Care-Giving For Future Research On Alzheimer Care, R Montgomery, Kristine Williams

Kristine N. Williams

As the primary caregivers for the millions afflicted with Alzheimer's disease, family members have been the focus of research for the past two decades. Differences in care patterns and deleterious effects of care provision have been clearly established. However, similar demands and hardships associated with care-giving result in different consequences for different families. A greater understanding of the care-giving context and its determinants will enhance knowledge of the differential impacts of care-giving. The most critical determinant of care-giving context is the role relationship between the caregiver and the care recipient. Future research must address role relationship as the primary determinant …

Written Language Clues To Cognitive Changes Of Aging: An Analysis Of The Letters Of King James Vi/I, Kristine Williams, Frederick Holmes, Susan Kemper, Janet Marquis

Kristine N. Williams

Reductions in language complexity normally occur in older adults because of decreased working memory and rate of language processing. Comparative measures can reveal whether linguistic change is due to normal aging or dementia. Linguistic analysis of a series of letters of King James, 1566–1625, investigate whether he exhibited a normative or atypical pattern of change. Fifty-seven letters from the years 1604 to 1624 were analyzed. Data modeling reveals a quadratic pattern of decline in written language complexity with increased diversity of vocabulary corresponding to historical reports of illness around 1618–1619. This investigation demonstrates how language analysis can provide valuable insight …