June 19, 2014

Journal of Gerontological Nursing April 2014



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

Guest Editorial 

Sensory Impairment: A New Research Imperative

When I answered the “so what” question for my past grant, Nursing Interventions for Sensory Impaired LTC Elders (unpublished grant proposal, 2005), I had compelling reasons for why nurses should investigate sensory impairment, specifically vision and hearing impairment in older adults. I could justify why it was important for nurses to partner with interprofessional colleagues to develop and test interventions to improve vision and hearing function that prevent or limit disability. p. 3-5 

NEWS HIGHLIGHTS
Citalopram Shows Promise for Treating AD-Related Agitation
According to a study published in the Journal of the American Medical Association, the antidepressant drug citalopram (Celexa®, Cipramil®) significantly relieved agitation in a group of patients with Alzheimer’s disease (AD). In lower doses than those tested, the drug might be safer than antipsychotic drugs currently used to treat the condition.
Clinical Study Completed for Neuroelectrophysiological Device
Neuronetrix has completed a significant clinical study milestone involving its proprietary Cognision System. The multi-year study was designed to evaluate the system’s ability to discriminate early-stage Alzheimer’s disease (AD) patients from age-matched healthy controls. The Cognision System is a proprietary neuroelectrophysiological device that provides objective assessments of cognitive function.
Pilot Program Keeps Older Adults with Dementia at Home Longer
An 18-month pilot program that brought resources and counselors to older adults with dementia and other memory disorders significantly increased the length of time they lived successfully at home. The program’s findings were published online in the American Journal of Geriatric Psychiatry.
Pesticide Exposure May Increase Risk and Severity of Alzheimer’s
A new study published online in JAMA Neurology reported that exposure to the pesticide DDT may increase the risk and severity of Alzheimer’s disease (AD) in some people, particularly those 60 and older. 

Geropharmacology 

Role of Nutraceuticals in Dementia CareAbstract


With an increase in the number of patients diagnosed with Alzheimer’s disease, it is not surprising that there is a consistent increase in use of nutraceuticals and other over-the-counter medications to combat memory complaints and ideally treat dementia. Throughout this review article, the authors highlight recent literature updates on B vitamins, vitamin D, vitamin E, omega-3 fatty acids, and gingko biloba. Similar to any other medication, it is imperative to evaluate the risks and benefits in older patients, especially in light of comorbidities and existing medications. p. 11–17.
 
Technology Innovations 

Older Adults’ Performance in Technology-Based Tasks: Cognitive Ability and Beyondstract


Considering both demographic and technological changes in society, the potential of technology to support older adults has recently attracted much attention. For physically frail individuals with cognitive impairment, user-friendly technologies may facilitate activities of daily living. The current study assessed the performance of older adults without cognitive impairment (n = 27) and with mild cognitive impairment (n = 26) using three types of technology. Relationships between performance in the technology-based tasks and cognitive abilities (e.g., visual-spatial abilities), personality characteristics (e.g., self-efficacy), and previous technology experience were examined using a mixed-methods approach including video analyses and psychological testing. Findings underscore that both cognitive abilities and personality-related characteristics contribute to individual differences in users’ performance. Nuanced knowledge of older adults’ specific difficulties, abilities, and resources may help improve the fit between user needs and technological requirements, with implications for technology developers and practitioners. p. 18–24.

 
Research Brief 

Psychiatric Illness and Resident Assaults Among Veterans in Long-Term Care Facilitiestract


This article describes a quality improvement program to reduce the prevalence of physical assaults in a university-affiliated, 234-bed Veterans Affairs (VA) long-term care (LTC) facility, which experienced a rise in the number of physical assaults to >4 per 1,000 bed days of care in four LTC units. Analysis of 55 events (29 patients) at this VA LTC site during 2007 revealed 19 resident assailants (8% total population), 10 victims, and 30% repeat events. Of the residents who exhibited assaultive behavior, 44% had dementia and 32% had schizophrenia as a major diagnosis. Following a process improvement plan, new occurrence assaultive behaviors declined from >4 to <1 per 1,000 bed days and remained low during 5-year follow up. p.  25–30 

CNE Article

The Health of Grandparents Raising Grandchildren: A Literature Review

Around the world, an increasing number of grandparents are raising grandchildren in households without a biological parent. This is no less true in the united states, where grandparents raising grandchildren are at increased risk for depression and declining physical health. The purpose of this article is to explore the recent literature as it relates to the psychological and/or physical health of grandparents raising grandchildren. On reviewing 19 articles from the past 10 years, it is clear that the literature consistently verifies the health risks, especially depression, for grandparents raising grandchildren; however, the lack of research regarding grandfathers and non-african american caregivers is apparent. The factors influencing grandparents raising grandchildren are numerous, which calls for care providers to assess the needs, situations, and perceptions of grandparents individually. Finally, a need has arisen for more research suggesting and validating interventions that health care providers can use to support this population of older adults. p.  32–42
 
Feature Article 

Promoting Person-Centeredness in Long-Term Care: An Exploratory Studystract


This study explored how nursing staff promote person-centeredness in long-term care settings. The study used an anthropological free-listing approach to data collection and qualitative content analysis to analyze written self-report descriptions from a convenience sample of Swedish long-term care staff (N = 436). The analyses resulted in four themes that illuminate how nursing staff promote person-centeredness: Promoting Decision Making, Promoting a Meaningful Living, Promoting a Pleasurable Living, and Promoting Personhood. The study contributes to the literature by providing concrete descriptions of how person-centeredness was facilitated by staff in their everyday practice and contributes to move person-centeredness from the philosophical, policy, and conceptual domains toward clinical implementation. The study also suggests that promoting pleasure for residents is a dimension central to person-centeredness and to health-promoting gerontological nursing, and that “small talk” is an emerging nursing phenomenon that deserves more research attention. p.  46–53

Feature Article 
Comparison of Family Satisfaction in Australian Ethno-Specific and Mainstream Aged Care FacilitiesAbstract

The aim in this study was to identify specific aspects of care that increased satisfaction of family members of Greek and Italian residents with dementia in mainstream or ethno-specific aged care facilities in Australia. Relatives of 83 aged care residents with Greek or Italian backgrounds who were also cognitively impaired were interviewed. They rated their satisfaction with the facility and suggested improvements regarding the care provided. Family members with relatives in ethno-specific care were more satisfied, in terms of the facility’s ability to meet the resident’s language and cultural needs, social/leisure activities, and the food provided. The presence of a bilingual staff member and greater perceived reduction in family caregiver stress upon admission were associated with higher satisfaction. Results implicate the role of activities programs, catering, resident interaction, supporting caregivers upon admission, and bilingual staff members to increase family satisfaction, with the potential to improve the care provided to residents in mainstream care. p. 54–63

 

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