October 15, 2014

Journal of Gerontological Nursing - September 2014

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

Product News 
Virtual Tour Allows Families To Walk in Shoes of Older Adult Loved Ones with Dementia
SWD has revamped the Family Edition to be more user friendly by lessening the clinical approach and implementing more practical approaches to dementia care. The Family Edition also includes a Family Guide, used post tour to provide strategies for empathetic care based on the family’s newly discovered knowledge gleaned from the VDT experience. 

·         Compound May Halt Clinical Progression of Alzheimer’s
·         Alzheimer’s May Be More Prevalent Among African Americans
·         Study Shows Community-Living Older Adults with Dementia More Likely to Be Hospitalized Than Those Without Dementia
·         New Glasses May Increase Fall Risk in Older Adults
·         Moderate-Intensity Physical Activity May Reduce Mobility Problems in Older Adults
·         Physical Work Environment in Hospitals May Affect Nurses’ Job Satisfaction

 Clinical Concepts 
Liver Transplantation in Older Adults
Liver transplantation is the only definitive treatment therapy for end-stage liver disease. In the United States, approximately 15% of annual liver transplant recipients are 65 or older. The most common postoperative complications are infection, acute graft rejection, and acute renal failure. To prevent complications, recipients are treated with immunosuppressive medications and anti-infective agents. The long-term complications of liver transplantation are a consequence of long-term use of immunosuppressive medications and recurrence of the original disease in the liver. Nurses play a critical role in supporting and educating recipients and their primary support persons about post-transplant follow-up care, including laboratory test schedules, medication management, and infection prevention. Strict compliance with follow-up care provides the greatest possibility of avoiding complications or organ rejection. [Journal of Gerontological Nursing, 40(9), 8–13.]

Public Policy 
Policy Implications of a Literature Review of Bariatric Surgery in Older Adults
In the past decade, bariatric surgery has garnered attention as a treatment for obesity in older adults. Its increased popularity is a direct response to growing obesity rates in this segment of the population. Bariatric surgery among older adults has emerged as a contentious issue debated by federal and state governments, health care providers, and patients. It is important for geriatric nurses to comprehend the policy and health implications of bariatric surgery for older adults. The purpose of this paper is to (a) discuss the burden of growing obesity rates on the health of older adults, (b) present the results of a literature review of bariatric surgery outcomes in older adults, and (c) evaluate the policy implications of insurance coverage of bariatric procedures. [Journal of Gerontological Nursing, 40(9), 14–19.]
CNE Article 
Multisensory Installations in Residential Aged-Care Facilities: Increasing Novelty and Encouraging Social Engagement Through Modest Environmental Changes
The current study examined the effect of an indoor simulated garden installation that included visual, auditory, and olfactory stimuli on resident well-being, compared to the effect elicited by a reminiscence installation and a control no-installation condition. A quasi-experimental aba design was used (i.e., two intervention conditions plus a wait-list control condition). A survey instrument was administered to nursing home residents (n = 33) at three time points (pre-, during, and post intervention) over an 8-week period, which measured mood, behavior, health, and social interaction. Additionally, staff reports (n = 24) were collected. Both the nature-based and non-nature-based installations led to enhanced well-being and significantly more social benefits for residents because of their novel and aesthetic appeal, compared with the control condition. Residents in the nature-based installation condition reported more satisfaction with their living environment during the intervention phase than those in the comparison conditions. The results show that an indoor garden simulation is a relatively inexpensive way to transform a disused indoor area of an aged-care facility for the benefit of residents and staff. [journal of gerontological nursing, 40(9), 20–31.]
Feature Article 
Using Targeted Messaging to Increase Physical Activity in Older Adults: A Review
Physical activity has many benefits for older adults; however, motivating older adults to engage in and maintain optimal levels of physical activity can be challenging for health care providers. A comprehensive literature review was performed to determine whether any evidence-based methods of delivery or particular content for targeted messaging exist that result in actual improvements in physical activity of older adults. Findings of the review demonstrate that messaging directed toward older adults to be physically active resulted in improvements in physical activity up to 1 year. Across studies many different modes of message delivery were shown to be effective. Message content, whether tailored or not, resulted in significant increases in physical activity. There is evidence to support the use of environmentally mediated messaging (i.e., local walking paths) for stronger results. Targeting the client’s stage of change, having an activity partner if preferred, and scheduling physical activity also contribute to improved effects. [Journal of Gerontological Nursing, 40(9), 36–48.]
Feature Article 
The Impact of an Acute Psychiatry Environment on Older Patients and Their Families
Ethnographic methods (observations and interviews) were used to investigate the physical environment of a geriatric psychiatry unit to understand how it meets the needs of patients with mental health conditions. Four interrelated themes of environmental qualities emerged as central in promoting healing: therapeutic, supportive of functional independence, facilitative of social connections, and personal safety and security. Therapeutic describes the existence of a home-like environment and quality sensory stimulations. Supportive of functional independence refers to the environmental features that make it easy for older adults to mobilize and perform activities of daily living. Facilitative of social connections indicates the provision of social spaces for patients, families, and staff to interact and engage in meaningful activities. Personal safety and security involves having staff in close proximity and minimizing disruptions from confused patients. The evidence suggests that the physical environment is important in making hospitals safe and supportive of healing for older adults with mental health conditions. [Journal of Gerontological Nursing, 40(9), 50–56.]


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