July 01, 2009

Journal of Gerontological Nursing

Vol. 35 No. 6 June 2009

Guest Editorial The Future of Health Care: Balancing Patient Care with (Reasonable) Profit excerpt During my 26 years of practicing nursing, I have frequently been baffled and frustrated by (and at odds with) administrators who seemed to lack compassion for others and make self-serving decisions that were detrimental to patients. As a clinician, I understood that administrators had to deal with nonclinical responsibilities such as budgets and staffing, but it often seemed as if they had forgotten that our ultimate goal was patient care. p. 3

Feature Articles
Positive and Negative Neuroplasticity: Implications for Age-Related Cognitive Declines Cognitive complaints and declines increase with age, which can interfere with everyday functioning and quality of life for older adults. With the increasing number of older adults, the need to promote successful cognitive aging will grow. Nurses, as health educators, will be increasingly called on to provide patients with information on how to avoid cognitive problems and accentuate cognitive abilities. This article provides some of the basic principles and ways of facilitating successful cognitive aging, such as positive and negative neuroplasticity and cognitive reserve, that can be incorporated into nursing education. 1.Neuroplasticity refers to the brain’s ability to change in response to environmental stimuli 2 Novel experiences promote positive Neuroplasticity as observed by the increase in connections between neurons 3 Methods of building up Neuroplasticity include mental stimulation and intellectual pursuits, exercise, proper nutrition, proper sleep hygiene and cognitive remediation. p. 11

Promoting Evidence-Based Dysphagia Assessment and Management by Nurses The Ottawa Model of Research Use guided the Hospital Elder Life Program nursing staff at a community hospital in promoting dysphagia assessment and management. The effect of an educational program and educational outreach on nurses’ knowledge retention and nurse-initiated speech language pathology (SLP) referrals were assessed. The sample consisted of 122 nurses. Repeated measures analysis of variance demonstrated significant differences among the pretest and posttests immediately after and at 2 and 6 months later (F[3,70] = 10.126, p 28

Incidence and Duration of Urinary Catheters in Hospitalized Older Adults: Before and After Implementing a Geriatric Protocol This study examined the incidence and duration of urinary catheters in acute care older adults before and after the implementation of a protocol developed to make clinicians aware of the appropriate use of catheters and the parameters for catheter removal. A total of 187 patients (99 pre-intervention, 88 post-intervention) age 65 and older admitted to a community hospital were assessed for the insertion of an indwelling urinary catheter using retrospective record review. A significant reduction was found in the incidence of indwelling urinary catheters in the post-intervention sample (from 33% to 15.3%, p = 0.006). There was a 20.4% reduction in the mean duration of urinary catheterization (from 4.9 days to 3.9 days). The catheter device-days were significantly reduced. p. 35

Enhancing Relationships in Long-Term Care Through Story Sharing Relationships

Between staff and residents in long-term care (LTC) are foundational to quality of life and high standards of care. Although nurse aides (NAs) provide more than 80% of personal care to nursing home residents, little research has focused on the NA-resident relationship or how NAs come to know and connect with their residents. This interpretive phenomenological study explored how a Story Sharing intervention initiates and enhances this relationship. Following the Story Sharing intervention, 84 volunteer NAs and 54 residents in six nursing homes were interviewed over a 6-month period. Analysis of these interviews revealed 9 patterns and 25 themes that describe how NAs and residents interact every day, along with innovative NA best practices. One theme, exemplifying a best practice, Restoring the Reciprocity of Care, is given. The findings have been incorporated into an extended Story Sharing Program for all LTC staff. p. 43

see Reading list on Risk reduction
* The brain that changes itself : stories of personal triumph from the frontiers of brain science Norman Doidge (2008)
*Can Alzheimer's Disease be prevented? National Institutes of Health (U.S.)
*It's never too late to change your mind : the latest medical thinking on what you can do to avoid dementia / Dr Michael J. Valenzuela

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