Geriatric Nursing Commons^™

Implementation And Evaluation Of An Oral Hygiene Program In Long-Term Care, Lawrence P. Lemos

Doctor of Nursing Practice (DNP) Projects

A review of the literature focusing on oral care within long-term care (LTC) suggests positive resident care outcomes occur when standardized practices are employed. Studies of staff education programs, trained oral hygiene aides, and dental hygienists working within LTC, have linked regular oral hygiene practices to decreased pneumonia rates. While these studies make the connection between good oral hygiene and reducing risk for pneumonia, best practices focused on implementing and sustaining an oral hygiene program in LTC facilities are lacking. The aim of this quality improvement project was to ensure that dependent residents in LTC receive assistance with daily oral …

Challenges Facing The Elderly Care Industry In Hong Kong: The Shortage Of Frontline Workers, Sin Tung, Stella Kwok, Wai Ning Kris Wong, Shun Lai Yang

Practical Social and Industrial Research Symposium

No abstract provided.

Evaluating The Perceptions Of Quality Of Life In Informal Caregivers Caring For Hospice Patients, Rashandra Fisher Laws

Doctoral Projects

Maintaining or improving quality of life for informal caregivers is important as they endure the burden of providing care to terminally ill loved ones on a daily basis. Caregivers are at a greater risk for depression, deteriorating physical health, financial difficulties, and premature death than demographically similar non-caregivers (Demiris et al., 2010). The goal of this capstone project was to determine the effectiveness of the creativity, optimism, planning, and expert information (COPE) intervention, which address specific needs of the family and caregiver.

Twenty informal caregivers completed the Quality of Life (QoL) Index tool, which measured their perceptions of five different …

An Evaluation Of Fall Prevention Interventions Among Older Adults In A Long Term Care Facility, Courtney Anita Bennett

Doctoral Projects

Falls are serious unwanted events that are a common occurrence among older adults in long term care facilities (LTC). Fall prevention in LTC facilities requires the efforts of an interprofessional team that promotes safety within an organization. The purpose of this capstone project is to implement and evaluate evidence-based fall prevention interventions at a LTC facility. Specific objectives of the project include: (a) providing education to healthcare professionals on evidence-based practices to recognize, assess, and prevent falls among older adults in a long term care facility and (b) replacing the existing fall prevention policy and program with a falls and …

Gender Relations In Hospice Palliative Home Care For Clients With Cancer And Their Family Caregivers: A Critical Analysis, Nisha S. Sutherland

Electronic Thesis and Dissertation Repository

The purpose of this study was to critically examine gender relations in the sociopolitical context of hospice palliative home care for clients with cancer and their family caregivers. Using a critical feminist lens, I employed critical ethnography as a methodology to uncover taken-for-granted attitudes, beliefs, and practices that shape health and health care experiences within the culture of end-of-life at home. The study addressed the following research questions: (a) How do gender relations shape health and health care experiences within the socio-political context of hospice palliative home care for clients with cancer and their caregivers?; (b) How do gendered processes …

Relationships Among Uncertainty, Coping, And Psychological Distress In Older Adults With Mild Cognitive Impairment, Jennifer Sjostedt Avery

Dissertations (1934 -)

Mild cognitive impairment (MCI) has an average prevalence of 18.9% and most often affects people 60 years of age or older. It is a cognitive stage between normal functioning and dementia (Petersen, 2003; Petersen, 2011; Petersen et al., 2014). MCI can be broken into two subtypes classified by the presence of memory impairment (amnestic MCI) or the lack thereof (nonamnestic MCI). Medical diagnostic criteria are commonly used to guide research with older adults with MCI. A theoretical framework that addresses the antecedents and consequences of MCI, specifically one examining the relationships among MCI, uncertainty, coping and psychological distress, is essential …

Subtypes Of Potentially Inappropriate Medications In Older Chinese-Americans During Care Transitions: Cross Sectional Retrospective Study, Sophia Hu, Janice Foust, Marie Boltz, Elizabeth Capezuti

Janice Foust

BACKGROUND: The number of Chinese Americans is growing and nearly 20% of older Chinese-American home care patients have at least one potentially inappropriate medications (PIMs) prescribed at hospital discharge. Further examination of PIMs during care transition is warranted, especially among older Chinese-Americans.

OBJECTIVES: To describe, during care transitions from hospital to home care: (i) the subtypes of PIMs, (ii) the difference of PIM prevalence prescribed at hospital discharge as compared to home care admission, (iii) the relationship between subtypes of PIMs, and (iv) issues affecting medication reconciliation among older Chinese-Americans.

METHODS: This cross-sectional, retrospective study was conducted in a large …

Five Dimensions Of Wellness And Predictors Of Cognitive Health Protection In Community Dwelling Older Adults: A Historical Collage Cohort Study, Kelley A. Strout Dr

Nursing Faculty Scholarship

Wellness is associated with cognitive health protection; however, findings are limited because they only examine variable(s) within one dimension of wellness. This research examined the association between multiple dimensions of wellness and cognition among aging adults. The sample included 5,605 male and female community-dwelling adults 60 years and older. Four dimensions of wellness demonstrated a statistically significant higher mean difference in cognitively healthy older adults compared to cognitively impaired older adults, F(4, 5,595) = 47.57, p < .001. Emotional wellness demonstrated the strongest association with cognitive health, followed by physical and spiritual wellness, F(5, 5,372) = 50.35, p < .001. Future research is needed to examine the cognitive protective benefits of wellness using longitudinal, prospective designs that control for the potential temporal relationship between wellness and cognition.DOI: 10.1177/0898010114540322

The Association Of Health Literacy With Self-Care Agency In Older Adults In Jamaica, Heather F. Fletcher

Loma Linda University Electronic Theses, Dissertations & Projects

Older adults are the fastest growing segment of the population in Jamaica. With an increase from 10% (252,225) of the total Jamaican population in 1995 to 11% (279,051) in 2005, the rate is expected to rise to 25% by 2025. Thus, it will be critically important to understand factors that may contribute to health maintenance, disease prevention, and wellness promotion. Two such factors – not studied extensively in this country - are health literacy and self-care. The purposes of this study were to (a) generate health literacy profile data with the newly-developed Health Literacy Questionnaire for community-dwelling older adults in …

A Novel Psychotropic Risk Assessment To Enhance Medical Management Of Patients With Behavioral And Psychological Symptoms Of Dementia, Nancy C. Trego

Doctor of Nursing Practice (DNP) Projects

There is growing evidence and concern documenting the risks of antipsychotic use, and psychotropic medication burden in general, for older adults with behavioral and psychological symptoms of dementia (BPSD). Yet nearly 25 percent of all long term care residents take antipsychotics for behavioral disturbances associated with dementia as “off-label” use, despite their modest efficacy and FDA black box warnings (CMS, 2013). Expert consensus calls for non-pharmacological strategies as the first line treatment, yet some patients with BPSD may require a combination of non-pharmacological interventions and pharmacological treatments for symptom reduction (AGS, 2011). The relief of debilitating symptoms aims to improve …

Primary Care At Home: Nurse Practitioners' Perceptions And Practices, Tonya Bragg-Underwood

Doctor of Nursing Practice Technical Reports

Background: Primary care at home is not a new idea, but rather a reinvention of an old and almost forgotten practice. Today, only 1% of primary care visits are provided in a home setting; despite the increasing aging homebound population in the United States. Current primary care at home research relates improved patient outcomes with primary care at home visits. Primary care at home is reemerging in the United States, but currently is not generating many positive reviews. There is a gap in the current primary care at home literature regarding nurse practitioner home visit practices and perceptions. Methods: A …

Results And Lessons Learned From A Nurse Practitioner-Guided Dementia Care Intervention For Primary Care Patients And Their Family Caregivers, Richard H. Fortinsky, Colleen Delaney, Ofer Harel, Karen Pasquale, Elena Schjavland, John Lynch, Alison Kleppinger, Suzanne Crumb

Articles - Patient Care

Older adults with dementia care needs often visit primary care physicians (PCPs), but PCP dementia care limitations are widely documented. This study tested the value of employing a nurse practitioner (NP) with geropsychiatric expertise to augment PCP care for newly and recently diagnosed patients and family caregivers. Twenty-one dyads received the NP intervention; 10 dyads were controls. Outcomes included patient neuropsychiatric symptom and quality of life changes, and caregiver depression, burden, and self-efficacy changes. Intervention acceptability by patients, caregivers, and PCPs was determined. No outcome differences were found; however, the NP intervention was deemed highly satisfactory by all stakeholders. Patients …

Honor The Molst, Teresa Guarino

Senior Honors Projects

End of life is a topic many people would rather avoid discussing. Even many healthcare providers are uncomfortable with the topic, and they are at the front line in terms of providing information to patients about their care options. Nevertheless, it is a topic of utmost importance. Regardless of what one values and what choices have been made, preferences and desires at the end of life should be honored. This was the aim of documents such as advanced directives, living wills, and durable power of attorneys for healthcare, but they have been found to not be consistently honored. Seeing this …

Pilot Study: Avoiding Readmissions Of Heart Failure Patients Across Transitions Of Care, Analiza Baldonado

Doctoral Projects

Background: A major problem facing the U.S. healthcare system is avoidable hospital readmissions. Patients with Heart Failure (HF) face variety of barriers to health care and are at higher risk for readmissions. To address this problem, evidence-based interventions focused on safe transition from hospital to home are needed.

Methods: A quality improvement pilot project was implemented to evaluate the feasibility of evidence based interventions in preventing avoidable readmissions. The project setting was in a 900 bed health care system. The descriptive statistical methods were means and frequencies. The Transition Coordinator (TC) enrolled a convenience sample of 30 participants. The evidence …

Awareness, Education, And Prevention Of Chronic Kidney Disease In The Older Adult, Torrel R. Bridges

Honors Theses

Chronic kidney disease (CKD) has become a major issue in our nation. Many of our neighbors, family, and friends have concerns and a call for our attention is necessary. CKD does not have a specific target, but individuals with diseases such as diabetes mellitus, cardiovascular disease, and obesity are all at increased risk. Adults older than 65 years of age are especially at increased risk for developing CKD due to decrease in kidney function and other physiologic changes. In light of this, awareness, education, and prevention of CKD in the older adult population is important.

The number of older individuals …

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.

An Assessment Of Nurses' Knowledge And Attitudes Toward End Of Life Care Pain Management, Amy Davis

Nursing Theses and Capstone Projects

This study was completed to help determine if nurses had a true understanding of how to provide pain management to patients in their care who were at the end of their life. A review of literature was completed and it revealed that nurses have a fear of opioid overdose and respiratory depression in their patients when providing proper pain management. It also revealed that patients have a fear of dying in pain at the end of their life especially if they have been diagnosed with a terminal illness. The study also revealed that when patients die in pain it actually …

Non-Pharmacological Interventions Project: Treatment For Dementia, Mandy Richards

Nursing Theses and Capstone Projects

In response to the Office of Inspector General's research report on atypical antipsychotic off label treatment of elderly dementia residents in long-term care, the Centers for Medicare and Medicaid Services developed a non-pharmacological intervention known as the Hand In Hand training tool. This projects focus was on training the direct care nursing staff with the Hand In Hand tool and evaluating for decrease in behavior and psychological symptoms in their patients. A retrospective chart review was utilized for the Minimum Data Sets tool Brief Interview of Mental Status (BIMS) and Mood interview. Pre training and post training scores were analyzed …

Sleep Disturbance And Outcomes In Patients With Heart Failure And Their Family Caregivers, Sami Al-Rawashdeh

Theses and Dissertations--Nursing

Sleep disturbance is common in patients with heart failure (HF) and the family caregivers. Sleep disturbance is known as a predictor of poor quality of life (QoL) in individual level. The manner in which patients’ and caregivers’ sleep disturbances influence each other’s QoL has not been determined. The purpose of this dissertation was to investigate the associations of sleep disturbance and outcomes in patients with HF and their primary family caregivers. The specific aims were to: 1) examine whether sleep disturbance of patients and their family caregivers predict their own and their partners’ QoL; 2) examine the mediator effects of …

Betsy: A Case Study Of A Client With Down's Syndrome And Dementia, Cheryl D. Schlamb, Christine D. Moriconi

Nursing Faculty Publications

No abstract provided.

Active Ageing In Pakistan: Challenges And Opportunities, Samina Vertejee, Noureen Nasruddin Karamali

Department of Surgery

Abstract

The increasing number of ageing population is a signpost for re-directing the resources to ensure quality of life for elderly thus promoting active ageing. However, the challenges to achieve the goal outweigh the opportunities due to scarcity of resources. Several factors including, brain drain, poverty, lack of knowledge of elderly to protect their rights in association with poor state laws determines the poor quality of life for elderly in Pakistan. Although, the apparent scenario is quite unpleasant yet there are several opportunities such as improved crude birth and death rates, increased awareness about gerontology as a specialty care area …

Things That Matter To Residents In Nursing Homes And The Nursing Care Implications, Nila Reimer

Nila Reimer

A move toward care of residents in nursing homes where they are respected and heard is finally emerging. Common strategies used in nursing homes to improve quality of care for residents are integration of person-centered care and assessing care using satisfaction surveys. Although approaches of integrating person-centered care and satisfaction surveys have been valuable in improving nursing home quality, strategies of care that include things that matter from residents’ perspectives while living in nursing homes need investigation. The purpose of this qualitative descriptive study was to describe things that residents age 65 and older state matter to them while living …