December 02, 2015

Journal of Gerontological Nursing Vol. 41 no. 11 November 2015



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

 New Ways to Predict Alzheimer’s Disease

Page: 7

Four studies suggest brain scans, memory tests, and body fluids (e.g., saliva) may hold the keys to understanding the likelihood of developing Alzheimer’s disease, even among individuals who do not yet have memory and thinking problems associated with the disease.

 

Helping Individuals With Dementia Live More Fully through Person-Centered Practices

Pages: 9-14

Dementia, including Alzheimer’s disease, is a health condition saddled with social stigmas and is widely misunderstood. Person-centered care practices can positively improve the psychosocial experience of living with dementia and have become the gold standard for care because of the resulting beneficial outcomes. The purpose of the current article is to describe four person-centered principles that form the foundation for dementia care practice: (a) the idea that individuals can and do live fully with dementia; (b) quality of life depends not only on the care received but also on the value that others put on their abilities and life; (c) being meaningfully engaged and having purpose are vital to well-being; and (d) respect, dignity, and choice are not only foundational to person-centered care but for basic human rights. Although efforts have been made to mandate person-centered practices, challenges remain that can direct future research and practice efforts.

 

Depression Detection in Older Adults With Dementia

Pages: 15-21

Depression and dementia are the two most common psychiatric syndromes in the older adult population. Depression in older adults with and without dementia often goes unrecognized and untreated. The current guideline recommends a three-step procedure that can be used across health care settings to screen for the presence of depressive symptoms. Implementation of the evidence-based guideline requires administration of the Mini-Mental State Examination and either the Geriatric Depression Scale Short Form or Cornell Scale for Depression in Dementia, depending on level of cognitive functioning. The algorithm provided is designed to be used by nurses, physicians, and social workers for the purpose of depression screening in older adults with dementia. Detection of depression in individuals with dementia is hindered by a lack of a validated, brief screening tool. More research is needed on the use of such screenings among older adults with cognitive impairment.

 

Comparing Person-Centered Communication Education in Long-Term Care Using Onsite and Online Formats

Pages: 22-28

Educating nursing home (NH) staff to provide person-centered care is complicated by scheduling, costs, and other feasibility issues. The current study compared outcomes for an in-service program focused on person-centered communication provided in onsite and online formats. The Changing Talk program was provided onsite in seven NHs (n = 327 staff). The online program included eight NHs (n = 211 staff). Analysis of variance revealed an interaction between format type and pre-/post-test scores with improved recognition of person-centered communication in the onsite group only. Group program evaluations based on the modified Diffusion of Innovation in Long-Term Care Battery indicated no significant differences between training formats. Staff perception of the program was similar. Although statistically significant gains were noted in posttest scores indicating awareness of person-centered communication for the onsite group, gains were of limited clinical significance. Feasibility and effectiveness are important considerations for in-service education supporting NH culture change.

 

Effects of the Evidence-Based Nursing Care Algorithm of Dysphagia for Nursing Home Residents

Pages: 30-39

Standardized nursing care protocols for dysphagia management have not been established in nursing home settings in Korea. The purpose of the current study was to examine the effect of the evidence-based nursing care algorithm of dysphagia (ENCAD) on risk of dysphagia, oral health, and dysphagia-specific quality of life among nursing home residents. The ENCAD was administered to 40 residents in one nursing home in urban South Korea for 6 months. A control-intervention, time-series design was used, under which participants served as their own controls. Oral health, risk of aspiration, and dysphagia-specific quality of life were measured at baseline, post-control, and post-intervention. Findings showed that risk of aspiration (p < 0.01) and dysphagia-related quality of life (p < 0.001) improved significantly after the ENCAD was applied, whereas oral health status did not change over time (p = 0.06). Results suggest that implementing the ENCAD  contributed to a reduction in the risk of aspiration and an improvement in the quality of life in nursing home residents.

 

Understanding Elderspeak from the Perspective of Certified Nursing Assistants

Pages: 42-49

Elderspeak is a form of patronizing speech that is often used with older adults. The current study attempted to learn more about the conditions under which elderspeak is used as well as the intent behind using elderspeak. The sample comprised 26 certified nursing assistants (CNAs) working with older adults in long-term care facilities. Data were collected using semi-structured interviews. Findings indicated that the intended purposes of elderspeak were to (a) make residents feel more comfortable, (b) make caregivers seem friendlier, (c) help residents better comprehend verbal communication, and (d) increase the likelihood that residents would cooperate during caregiving tasks. In addition, one half of the CNAs reported that elderspeak is more appropriate with individuals with dementia; many also believed that the use of elderspeak was always inappropriate. The current findings may have implications for improving training and education programs for CNAs and other professionals working in long-term care facilities.

 

Nutrition and Cognition in Older Adults With Heart Failure

Pages: 50-59

Cognitive impairment is commonly observed in older adults with heart failure; nutrition is a possible contributing factor. The purpose of the current systematic review is to examine the relationship between nutrition and cognition in older adults with heart failure. A literature review was performed through August 2015 that examined published, peer-reviewed studies from PubMed, PsycINFO, CINAHL, and Web of Science. Four articles were selected for inclusion. Findings revealed that poorer nutritional habits were associated with poorer attention, executive functioning, and memory in older adults with heart failure. Nutritional biomarkers, including anemia, hyponatremia, hypokalemia, hyperglycemia, and hypoalbuminemia, were also associated with cognitive impairment. More research is needed to explore the relationship between nutrition and cognition in this population. Descriptive studies will inform scientists as they design and test nutritional interventions to optimize cognitive function in older adults with heart failure.

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