Journal of Gerontological Nursing

Published by Slack
Online ISSN: 0098-9134
Publications
Article
1. The move to a long-term care facility often strips elders of self-control and decision-making, leading to a sense of powerlessness and low self-esteem. 2. Life is measured day to day. Restoring choices in activities of daily living, nutrition and fluids, and social activities allows clients to function at maximum autonomy while reducing the workload of staff. 3. The key is a change of focus. Innovative changes providing variety and choice in long-term care facilities are achievable and cost-effective.
 
Article
The purpose of this article is to compare the advantages and limitations of developed depression assessment tools and provide recommendations for clinical staff to select an appropriate tool for use with Chinese older adults. A total of 7 Western tools translated into Chinese and 4 tools developed specifically for assessing Chinese older adults were found in 12 articles. Variability in instrument psychometric properties and cutoff scores is discussed. A reasonable strategy to efficiently assess depression in Chinese older adults is to first administer the Single Question or Geriatric Depression Scale-4 (GDS-4). If depression is likely, the Chinese GDS-15 could be used to increase the probability of identifying depression in Chinese older adults.
 
Article
All articles published between 1991 and 1997 in the Journal of Gerontological Nursing and Geriatric Nursing were classified as qualitative research, quantitative research, or non-research. Of the 784 articles reviewed, 5.1% mentioned religion or spirituality. Research articles (7.7%) were more likely than non-research articles (2.8%) to address religion and spirituality. No statistical difference was found between the percentage of qualitative (10.7%) and quantitative (6.8%) studies addressing religious and spiritual factors. The percentage of quantitative studies including religious and spiritual variables was found to be higher than that found by systematic reviews of the research literature in various health professions.
 
Article
The purpose of this study was to complete an integrated literature review of the relationship between staffing and quality outcomes in nursing homes. The majority of the reviewed studies showed better outcomes with higher nursing staff but depended heavily on cross-sectional observational studies and failed to differentiate RNs from other nursing staff. A total of 28 articles relating nurse staffing and quality outcomes were systematically reviewed and synthesized. However, each study examined different aspects of staffing and different resident or organizational outcomes, making determination of appropriate staffing levels difficult. The reviewed studies have not clearly defined the relationship between differing levels of nurse-staffing skill mix and specific structure, process, outcome, and composite indicators of quality. The inconsistent findings suggest that further research is needed in this area.
 
Article
Because 90% of all institutionalized elderly have a hearing impairment, nurses in long-term care facilities need to improve the care of the hearing impaired patient and contribute to increasing communication access. The purpose of the Hearing Access 2000 program is to make public facilities more accessible by increasing awareness of the needs of the hearing impaired. Implementation of the program includes an inventory of hearing aids, staff in-service programs, use of assistive devices, otoscopic examinations, cerumen removal protocol, and the use of tent cards, buttons, and posters.
 
Article
The word "aging" is fraught with nuance, both positive and negative. The purpose of this article is to describe the results of a preliminary exploration of the ambiance of the concept of aging in the United States as seen from the perspective of periodical literature from the past century. A convenience sample of professional journals and lay periodicals concerned with aging and the issues of aging was selected as the focus for this investigation. Specifically, volume one, number one of the selected journals was examined with regard to the date of the first publication, the table of contents, and the first issue editorial or articles in the first volume describing the motivation for the introduction of the journal. Findings indicated that as the century progressed and the study of aging took form, the focus shifted from how to manage the problems of aging to: (a) how to promote healthier young adult lifestyles to increase the chances of a healthy old age, (b) how to continue to maintain older adults' health and therefore, increase the life expectancy for those people older than age 65, and (c) how older adults contribute to the well-being of society. The longevity of the human species, as well as the increasing size of the aging population is a new phenomenon, the ramifications of which are difficult to predict. However, as the emotional tone of the journals in the latter quarter of the century gradually became more positive, it was apparent that consideration was being given to the idea that this phenomenon could be a positive force in the collective growth of humanity.
 
Article
The approaching millennium brings not only a muted but also a challenging vision for the future of gerontological nursing. This vision is muted by the rhetoric of the 90s dictating the elimination of costly programs with the potential to diminish quality. It is a vision of challenge to advocate for, protect, demand, and create a new framework that will guarantee high-quality health care for older patients. In an attempt to clarify that vision, this article outlines three areas of gerontological nursing: education, practice, and research. The future direction in these areas will dictate how collective thinking can support health care for older people in the next century and beyond. These components of nursing must be integrated to develop quality care needed by older patients.
 
Article
The Skills Immersion Program (SKIP) provides an educational opportunity for staff nurses who face the challenge of caring for residents who present with psychiatric and behavioral problems in long-term care (LTC) facilities within British Columbia, Canada. With the aging population and an increase in the number of individuals waiting for placement in care facilities, care providers are in substantial need of advanced education and training in the field of geriatric psychiatry nursing. Nurses working in LTC facilities in Canada are not prepared to manage the changing acuity levels and complex needs of their residents. The SKIP was developed by nurses, primarily for nurses, at St. Vincent's Hospital in Vancouver, British Columbia, Canada. Nurses who participate in the SKIP acquire an enhanced knowledge base in geriatric psychiatry nursing and gain access to assessment tools that will assist staff to increase the quality of care for their residents.
 
Article
In the past century, there has been a substantial increase in the number of older Americans and an increase in their life expectancy at birth. These trends will continue over the next century, marked by further increases in active life expectancy and marked changes in the racial and ethnic composition of the older population. While nursing has traditionally focused on the care of frail older individuals, most older adults--well older adults--enjoy a relatively high level of health and function. In this article, well older adults are defined as those with the physical, mental, social, and spiritual function or resources to meet the needs of everyday living. Recommendations for improving care of well older adults are provided, including reconceptualizing ways of thinking, expanding practice initiatives, building the science of nursing research in geriatrics and gerontology, developing education and training opportunities, and rethinking individual safety within the context of autonomy.
 
Article
Wellness is within the grasp of all persons, no matter what age. Gerontological nurses, in care partnerships with other disciplines and business and health organizations, still have numerous opportunities in their communities to contribute to the well-being of aged individuals. Only 68% of the sentinel objectives established by The Public Health Service in Healthy People 2000 have shown improvement (Peterson, 1996). There is still room for development of the Healthy People 2000 initiatives and various opportunities for gerontological nurses to assist elders on their journey to wellness.
 
Results of multivariate logistic regression analyses to predict pain 
Impact of pain, demographic and health status characteristics on quality of life 
Article
Pain is a frequent and debilitating problem among older adults, decreasing quality of life (QOL) both physically and mentally. The burden of arthritis, sciatica, and back pain on QOL was estimated using ordinary least squares regression techniques to estimate the impact of each of these types of pain on QOL, controlling for patient demographic, socioeconomic, and health status characteristics. For individuals with arthritis, sciatica, and back pain, the adjusted average physical component scores were 4.19, 1.39, and 6.75 points lower, respectively (all p < 0.0001), than those without pain. Adjusted average mental component scores were 1.33, 0.47, and 2.93 points lower (all p < 0.01) for individuals with arthritis, sciatica, and back pain, respectively. The impact of pain on QOL was greater than that for many other commonly treated medical conditions. Clinicians should discuss pain with their patients to maximize their QOL.
 
Article
The issue of driving in the elderly population will continue to be relevant for public discourse. Because the termination of driving may be seen as an end of independence, it is important to appreciate that it has both emotional and pragmatic consequence. Senescence includes a host of physiological changes that may influence one's driving ability. Yet, aging alone does not infer poor driving ability. Health care providers should encourage and support the development of accurate methods of evaluation for older drivers and discuss adaptive strategies with older drivers in an effort to maintain their independence while promoting public safety.
 
Article
1. There are a number of common health problems of the elderly that have the potential to be prevented, postponed, or reversed even after age 65. 2. The nurse's knowledge of the difference between normal aging and a disease process is essential to enable the nurse to detect whether a health problem can be prevented, postponed, or reversed. 3. It is being discovered that there is an alarmingly high number of seniors whose "dementia" is not permanent, but rather is reversible or treatable.
 
Article
Resilience in women older than 85 is defined as the ability to achieve, retain, or regain a level of physical or emotional health after devastating illness or loss. This concept analysis of resilience in women older than 85 is based on the strategy suggested by Meleis. Resilience in women older than 85 is symbolized by a coiled wire, enclosed within a box similar to a jack-in-the-box. Environmental factors within the jack-in-the-box include frailty, determination, previous experience with hardship in learning how to cope, access to care, culturally based health beliefs, family support, self-care activities, caring for others, and functioning like efficiently working machines. External factors that influence the ability of the wire to recoil include the structure of the box itself and stress. More study is needed regarding diverse older women's experiences of resilience to develop a workable, clinically focused theory.
 
Article
This study examines perspectives of a broad group of nursing home employees, regulators, advocates, and professional associations to describe progress made since the 1990 implementation of the Nursing Home Reform legislation (OBRA '87) and to determine whether the legislation is perceived as effecting positive change for nursing home residents. Interviews were conducted with 132 professional and non-professional staff in six states and 56 residents. Important issues about nursing home staffing and quality of care are explored. In general, OBRA '87 is viewed as positive, with all groups of respondents indicating that nursing staff or quality have not deteriorated; administrators, licensed nurses, and certified nursing assistants indicate the quality of nursing care provided and the nursing staff levels have improved since OBRA '87 implementation. Regulators agree that quality of nursing care has improved, but nursing home advocates, regulators, and professional association staff indicate mostly no change or no opinion. There is a danger in interpreting that quality and staffing are adequate from these results. While both may have improved, they may not be adequate.
 
Article
This study examines perspectives of a broad group of nursing home employees, regulators, advocates, and professional associations to describe progress made since the 1990 implementation of the Nursing Home Reform legislation (OBRA '87) and to determine whether the legislation is perceived as affecting positive change for nursing home residents. Interviews were conducted with 59 residents and 132 professional and non-professional staff in six states. Important quality of care issues of resident rights, resident dignity, restraint use, resident assessment, as well as perspectives of residents themselves are explored. In general, OBRA '87 is viewed as positive, with all groups of respondents indicating that residents have benefited from it. They identify the focus on resident rights as the most important accomplishment. Empowerment of residents through involvement in care decisions is noted by many as an important achievement. Many conclude that quality of care has improved and restraint use has decreased. The MDS is a useful tool from the standpoint of nursing home staff and regulators. This appraisal sharply contrasts their opinions about the Preadmission Screening and Resident Review (PASARR) screening tool. We believe that PASARR should be reexamined and that changes should be made in the process and/or implementation of the tool.
 
Article
Social participation is a criterion for successful aging. Research has shown that social participation decreases in older adults. However, the role of social support on older adults' social participation has received little attention, especially in eastern countries, such as Iran. Using the Social Participation Questionnaire, the relationship between social support and social participation was investigated in 525 Iranian older adults. A correlation was found between social support and social participation of older adults. Older adult women were found to have less social support and social participation compared with men. [Journal of Gerontological Nursing, xx(x), xx-xx.]. Copyright 2015, SLACK Incorporated.
 
Article
A recently proposed interprofessional, evidence-based, multicomponent approach to mitigating the effects of intensive care unit (ICU)-acquired delirium and weakness has the potential to radically transform the way care is delivered to older adults requiring sedation, mechanical ventilation, or both. The Awakening and Breathing Coordination, Delirium Monitoring and Management, and Early Mobility (ABCDE) bundle empowers members of the interdisciplinary ICU team to implement the best available evidence regarding mechanical ventilation, sedation, weakness, and delirium in a safe, effective, and patient-centered manner. Considering that critically ill older adults are cared for in a number of different settings during the course of hospitalization and recovery, the purpose of this article is to explore the rationale and possible benefits of extending the ABCDE bundle into the post-ICU setting. We provide a case study that illustrates how ABCDE bundle adoption could be the key to improving the quality of care provided to seriously ill older adults in the ICU and beyond.
 
Article
Risk of falling is a major concern of long-term care facilities with residents diagnosed with dementia. Use of a brief cognitive assessment focusing on visual spatial abilities could be one strategy in the prevention of falls in residents with dementia. The objective of this study was to determine if a clock test could predict a risk of falls in residents diagnosed with dementia. Three hundred sixty-four individuals with dementia participated (92 men and 272 women; ages 37 to 100, mean 80.5 years, median 83 years). Each participant was given the Reality Comprehension Clock Test (RCCT) three times, and Mini Mental-Status Examination (MMSE) two times to determine criterion-related validity, test-retest reliability, internal consistency; and to set and evaluate a risk of falls score based on the Visual Spatial Score (VSS) component produced by the RCCT. Significant findings included .72 (p < .01) correlation between the RCCT and the MMSE, .90 (p < .01) correlation between the first administration of the RCCT and the second administration of the RCCT; an alpha of .95 (p, < .001) and an F value of 7.6 (p < .001) producing a risk of falls initial VSS of 5 or lower compared to 9 or greater. Chi-square of 6.3 for 30 days (p,< .01), 11.08 for 60 days (p < .01) and 13.3 for 90 days (p < .01) indicated a significant difference in the number of falls occurring in the high risk group (VSS of 5 or lower) compared to the low/ no risk group (VSS of 9 or higher). A risk factor analysis suggested that residents in the higher risk group were three times more likely to have fallen than residents in the low risk group. Knowing a resident's visual spatial ability offers health care providers an opportunity to implement a resident-specific intervention that addresses their cognitive ability and visual spatial deficit that may reduce the resident's risk of falling.
 
Top-cited authors
Donna M Fick
  • The Pennsylvania State University, University Park, United States
Kathleen Buckwalter
  • University of Iowa
Barbara Resnick
  • University of Maryland, Baltimore
Marilyn Rantz
  • University of Missouri
Keela Herr
  • University of Iowa