May 12, 2014

Journal of Gerontological Nursing February 2014

Full text articles are available to fee paying members of Alzheimer’s Australia NSW by emailing NSW.Library@alzheimers.org.au

Guest Editorial
Aging is one individual’s unique journey through life. Becoming a “senior” allows one to review and reminisce about life’s hopes, dreams, plans, realities, opportunities, setbacks, joys, frustrations, accomplishments, and disappointments. Life’s journey teaches everyone that the only constant is change.
p. 3-4 

News highlights p. 5-9
  • Study finds method to predict Alzheimer’s within 2 years of screening
  • Meditation may help slow progression of Alzheimer’s Disease
  • Free interactive program available for improving care for dementia patients
  • Positive data released for Alzheimer’s gene therapy approach
  • First human trial of Selective Muscarinic M1 receptor agonist for Alzheimer’s Disease initiated
Diagnosis: Dementia
It is estimated that 90% of nursing home residents need assistance with bathing. The purpose of this article is to describe a music-assisted care technique that can be used by caregivers when bathing nursing home residents with dementia. Research suggests that music has many therapeutic benefits for people with dementia. Using music to soothe anxiety can be an effective intervention to assist with lessening of agitation during activities of daily living, especially bathing. This article will provide nursing and direct care staff tools to successfully conduct the music-assisted bathing protocol. Consideration for choosing appropriate music for bathing, the creation of individualized personalized playlists, and acknowledgement of desired outcomes are presented. Incorporating music-assisted bathing may address neuropsychiatric symptoms of dementia by lessening agitation and improving mood, which in turn can increase job satisfaction.
p.  9–13

Evidence-Based Practice Guideline
When people with dementia residing in an institution require assistance with bathing, the process is complicated by the culture, values, and expectations of people who assist with the bath. Seemingly simple concepts such as what is clean versus what is dirty and how one responds to what he or she perceives can trigger conflicts. Moreover, in an institutional setting there are policies, rules, and traditions of care that might trump individual needs and beliefs. There are also regulatory standards that must be followed and issues related to economies of scale. What may seem like a simple bath to assistants may be perceived as a personal attack and result in resistance due to high levels of anxiety, agitation, and aggression.
p. 14-20
Research Brief
Transitions in care tend to be difficult and complicated periods for older adults, families, and staff in long-term care facilities. For some older adults, care activities and care environments in facilities can lead to adverse reactions, such as resisting assistance with care or agitation and anxiety. Unfortunately, current tools do not adequately assess for triggers to such behaviors. In the current study, the 8-item Adverse Reactions to Care (ARC) scale was developed and tested with 89 older adults and their caregivers (N = 89). Exploratory factor analysis revealed the ARC scale loaded onto two distinct factors: (a) reactions to care activities and (b) reactions to care environments, with high overall reliability (alpha = 0.84). With additional testing, the ARC scale may be useful for clinicians in long-term care settings and for researchers focused on understanding care transitions for older adults.
p. 21–25
CNE Article
Proper management and prevention of dysphagia is an urgent need of long-term care for older adults in Korea. However, no screening tools with high sensitivity and accessibility have been validated within korean nursing home settings. The purpose of this study was to validate a screening tool for nurses to identify dysphagia and aspiration risk in nursing home residents. Rns screened 395 residents from two nursing homes in south korea using the korean version of the standardized swallowing assessment (k-ssa). Results were validated against those from the gugging swallowing screen (guss). Compared to results from the guss, with 9-point and 14-point cutoffs, the k-ssa had a sensitivity of 0.94 and specificity of 0.65 for screening dysphagia and 0.86 sensitivity and 0.71 specificity for screening aspiration risks. The k-ssa demonstrated excellent sensitivity and specificity for screening individuals at risk of dysphagia and aspiration when used by rns in nursing homes.
p.  26–35
Feature Article
Remembrance of recent events is a major problem for individuals with dementia. Consequently, this article explores the process of acceptance and integration of a digital photograph diary (DPD) as a tool for remembrance of and conversations about daily life events. A design for multiple case studies was used. Seven couples, in which one individual in the couple had Alzheimer’s disease, tested the DPD for 6 months. Data were collected in three sequences with interviews, observations, and screening instruments. In the analysis, all data were integrated to find common patterns of content. Some couples became regular users, while others used the DPD more sporadically. Factors contributing to regular use were how the DPD matched expectations, actual use, support, experienced usefulness, and reactions from family and friends. For those couples who became regular users, the DPD facilitated their conversation about recent daily activities.
p.  38–46
Feature Article
**Lynnette Chenoweth, RN, BA, MA(Hons), PhD; Lee-Fay Low, BScPsych(Hons), PhD; Belinda Goodenough, BA(Hons), PhD; Zhixin Liu, BMed, MApplStat, PhD; Henry Brodaty, MBBS, MD, DSc, FRACP, FRANZCP; Anne-Nicole Casey, BA(Hons); Peter Spitzer, MD; Jean-Paul Bell; Richard Fleming, PhD
Abstract

Life in residential care can be challenging for residents and staff. Bringing humor into this setting may benefit residents, creating a more productive, enjoyable work environment for staff. The potential effect of exposure to humor therapy on staff, both as active and incidental participants, as part of a randomized controlled trial of the effect of humor therapy for aged care residents was investigated in the Sydney Multisite Intervention of LaughterBosses and ElderClowns (SMILE). The intervention involved a humor program with professional performers (ElderClowns) and trained facility staff (LaughterBosses) for a minimum of nine 2-hour sessions over 12 weeks. Methods included a staff survey at three time points, interviews with LaughterBosses, and a satisfaction rating by facility managers. There were significant positive findings for some staff subgroups, including assistants in nursing/personal care assistants and staff older than 45. LaughterBoss interviews and intervention group manager ratings of staff work enthusiasm were positive.
 p. 47–52.

 


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