November 20, 2015

Journal of Gerontological Nursing September 2015



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

Dehydration in the Older Adult
Pages: 8-13

Abstr

Dehydration affects 20% to 30% of older adults. It has a greater negative outcome in this population than in younger adults and increases mortality, morbidity, and disability. Dehydration is often caused by water deprivation in older adults, although excess water loss may also be a cause. Traditional markers for dehydration do not take into consideration many of the physiological differences present in older adults. Clinical assessment of dehydration in older adults poses different findings, yet is not always diagnostic. Treatment of dehydration should focus on prevention and early diagnosis before it negatively effects health and gives rise to comorbidities. The current article discusses what has most thoroughly been studied; the best strategies and assessment tools for evaluation, diagnosis, and treatment of dehydration in older adults; and what needs to be researched further.

 
Looking Ahead After 50 Years of Medicare

Pages: 15-18

Fifty years of Medicare have led to enormous improvements in care of older adults in the United States. Policy changes in Medicare and Medicaid have undergirded the care of older adults and the workforce and professional development of nurses and advanced practice nurses. Reflecting on the decades of change in these 50 years and the context in which these changes occurred can prepare health care providers for future strategies to address needs of the rapidly growing older adult population.


Frail older Adult’s Experiences With a Proactive, Nurse-Led primary Care Program


Pages: 20-29

The aim of the current study was to explore frail older adults’ perceptions and experiences with a proactive, integrated nurse-led primary care program. A qualitative study nested within a randomized trial in primary care was conducted. In total, 11 semi-structured interviews were conducted in a subsample of participants who received nurse-led care in the intervention group. Generally, proactive, nurse-led care was well-received and four different nursing roles were observed: (a) monitor, (b) director, (c) coach, and (d) visitor. The monitor role (i.e., observing and assessing potential risks) was perceived as the most important. The relationship with the nurse, timing of visits, and provided care, as well as tailoring the care to individual needs, were identified as conditions related to appreciation. If the care was well-regarded, older adults were more likely to accept it, which helped them anticipate changes or handle consequences of aging more easily.

Striving for Excellence


Pages: 32-41

The purpose of the current study was to explore how Minimum Data Set (MDS) coordinators perceive their role and the assessment process. Eleven MDS coordinators from 10 geographically dispersed nursing homes (NHs) were interviewed between May and September 2013. Four broad themes emerged from content analysis: (a) information gathering, (b) interdisciplinary coordination, (c) role challenges, and (d) resources. The first two themes referred to key components and competencies in the MDS coordinators’ role, the third theme dealt with certain challenges inherent in the role, and the fourth theme highlighted resources that helped address these challenges. The current study provides insight into how MDS coordinators perceive their role, as well as some of the challenges they face to successfully enact that role. The current findings can help inform NH management staff, such as directors of nursing and NH administrators, and policy makers, on how best to support MDS coordinators’ work to enable efficient and accurate resident assessment processes.

 

If They Were Real – Lessons learned from Literary characters With Dementia

*all the following books are available-  if you would like to reserve a copy - please email the Library at nsw.library@alzheimers.org.au
Pages: 42-47

Dementia and its side effects often leave individuals unable to tell their stories or experiences. Consequently, nurses must rely strictly on clinical observations as a basis for understanding dementia — an understanding that is necessary to provide the best possible care. Relying on clinical observations leads to challenges in fully understanding the experience of living with dementia. Fictional literature gives authors license to write about individuals with dementia rather than the clinical aspects of the disease, which provides insight into the patient and family experience and illustrates their needs. The current article explores dementia through an analysis of eight literary works and insights that may help expand the quality of geriatric nursing care.
Examines :
  • "Still Alice" By Genova -Alice Howland is proud of the life she worked so hard to build. A Harvard professor, she has a successful husband and three grown children. When she begins to grow forgetful, she dismisses it for as long as she can, but when she gets lost in her own neighbourhood she knows that something has gone terribly wrong. She finds herself in the rapidly downward spiral of Alzheimer's Disease. She is fifty years old. Suddenly she has no classes to teach, no new research to conduct, no invited lectures to give. Ever again. Unable to work, read and, increasingly, take care of herself, Alice struggles to find meaning and purpose in her everyday life as her concept of self gradually slips away. But Alice is a remarkable woman, and her family, yoked by history and DNA and love, discover more about her and about each other, in their quest to keep the Alice they know for as long as possible. Losing her yesterdays, her short-term memory hanging on by a couple of frayed threads, she is living in the moment, living for each day. But she is still Alice.
  • "Dad " by Wharton - After being summoned home by the news of his mother's heart attack, John Tremont is forced to confront his own middle age. While John's mother begins to make an astonishing recovery, his father deteriorates; having long ago handed over the running of his life to his domineering wife, he is unable to cope without her. With the help of his nineteen-year-old son, John assumes the role of carer. Before long, John finds himself caught between his son's feckless impatience to get on with his life and his father's heartbreaking willingness to let go, as both sons become trapped in the consuming, terrifying and repetitive world of looking after a dying loved-one.
  • The Last First Day  Carrie Brown From the author of The Rope Walk, here is the story of a woman's life in its twilight, as she looks back on a harrowing childhood and on the unaccountable love and happiness that emerged from it.�Ruth has always stood firmly beside her upstanding, brilliant husband, Peter, the legendary chief of New England's Derry School for boys. The childless couple has a unique, passionate bond that grew out of Ruth's arrival on Peter's family's doorstep as a young girl orphaned by tragedy. And though sometimes frustrated by her role as lifelong helpmate, Ruth is awed by her good fortune in her life with Peter. As the novel opens, we see the Derry School in all its glorious fall colors and witness the loosening of the aging Peter's grasp: he will soon have to retire, and Ruth is wondering what they will do in their old age, separated from the school into which they have poured everything, including their savings. The narrative takes us back through the years, revealing the explosive spark and joy between Ruth and Peter-undiminished now that they are in their seventies-and giving us a deeply felt portrait of a woman from a generation that quietly put individual dreams aside for the good of a partnership, and of the ongoing gift of the right man's love.
  • One Hundred Years of Solitude
    Equally tragic, joyful and comical, Gabriel García Márquez's masterpiece of magical realism, One Hundred Years of Solitude is a seamless blend of fantasy and reality, translated from the Spanish by Gregory Rabassa in Penguin Modern Classics.Gabriel García Márquez's great masterpiece is the story of seven generations of the Buendía family and of Macondo, the town they have built. Though little more than a settlement surrounded by mountains, Macondo has its wars and disasters, even its wonders and miracles. A microcosm of Columbian life, its secrets lie hidden, encoded in a book and only Aureliano Buendía can fathom its mysteries and reveal its shrouded destiny. Blending political reality with magic realism, fantasy with comic invention, One Hundred Years of Solitude is one of the most daringly original works of the twentieth century.Gabriel García Márquez (b. 1928) was born in Aracataca, Colombia. He is the author of several novels, including Leaf Storm (1955), One Hundred Years of Solitude (1967), The Autumn of the Patriarch (1975), Chronicle of a Death Foretold (1981) and The General in His Labyrinth (1989). He was awarded the Nobel Prize for Literature in 1982.If you enjoyed One Hundred Years of Solitude, you might like Love in the Time of Cholera, also available in Penguin Modern Classics.'With a single bound Gabriel García Márquez leaps on the stage with Günter Grass and Vladimir Nabokov ... dazzling'The New York Times
  • The Bear Came Over the Mountain by Alice Munro.Grant and Fiona have been married for forty-five years. When Fiona shows signs of deteriorating memory, they realize she needs to live in a nursing home. During her first 30 days there -- during which Grant is not permitted to visit -- Fiona seems to forget her marriage to Grant and develops a strong attachment to a resident named Aubrey.( in Hateship, Friendship, Courtship, Loveship, Marriageby Munro, Alice )
  • Life Drawing Robin Black
    Augusta and Owen have taken the leap. Leaving the city and its troubling memories behind, they have moved to the country for a solitary life where they can devote their days to each other and their art, where Gus can paint and Owen can write. But the facts of a past betrayal prove harder to escape than urban life. Ancient jealousies and resentments haunt their marriage and their rural paradise. When Alison Hemmings moves into the empty house next door, Gus is drawn out of isolation, despite her own qualms and Owenâe(tm)s suspicions. As the new relationship deepens, the lives of the two households grow more and more tightly intertwined. It will take only one new arrival to intensify emotions to breaking point. Fierce, honest and astonishingly gripping, Life Drawing is a novel as beautiful and unsparing as the human heart.
  • The Arsonist by
    Troubled by the feeling that she belongs nowhere after working in East Africa for 15 years, Frankie Rowley has come home-home to the small New Hampshire town of Pomeroy and the farmhouse where her family has always summered. On her first night back, a house up the road burns to the ground. Is it an accident, or arson? Over the weeks that follow, as Frankie comes to recognize her father's slow failing and her mother's desperation, another house burns, and then another, always the homes of summer people. These frightening events, and the deep social fault lines that open in the town as a result, are observed and reported on by Bud Jacobs, a former political journalist, who has bought the local paper and moved to Pomeroy in an attempt to find a kind of home himself. As this compelling book unfolds, as Bud and Frankie begin an unexpected, passionate affair, arson upends a trusting small community where people have never before bothered to lock their doors; and Frankie and Bud bring wholly different perspectives to the questions of who truly owns the land, who belongs in the town, and how, or even whether, newcomers can make a real home there
 


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