{"title":"Do-Not-Hospitalize Orders in Assisted Living Facilities: Direct Care Workers' Perspectives","authors":"Alanna Dancis, DNP, AGPCNP","doi":"10.3928/00989134-20240311-02","DOIUrl":"https://doi.org/10.3928/00989134-20240311-02","url":null,"abstract":"<section><h3>Purpose:</h3><p>To gather sufficient qualitative data to create an intervention that would prevent direct care workers (DCWs) from sending residents with do-not-hospitalize (DNH) orders to the hospital.</p></section><section><h3>Method:</h3><p>This was a qualitative study with eight participants that included a descriptive survey followed by semi-structured interviews.</p></section><section><h3>Results:</h3><p>DCWs were unfamiliar with DNH orders and their thinking on end-of-life care was binary (hospice or hospital) and protocol driven. However, supportive leaders were able to help DCWs problem-solve these complicated scenarios. Results were mixed on whether having a RN on site was helpful.</p></section><section><h3>Conclusion:</h3><p>DCWs may benefit from having access to a nurse with palliative care experience when making decisions about residents with DNH orders. [<i>Journal of Gerontological Nursing, 50</i>(4), 11–15.]</p></section>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"212 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dementia-Related Disparities in Adult Day Centers: Results of a Bivariate Analysis","authors":"Jonelle Bofao, MPH, Marissa Bergh, BSN, RN, Amy Zheng, Tina Sadarangani, PhD, RN, ANP-BC, GNP-BC","doi":"10.3928/00989134-20240313-01","DOIUrl":"https://doi.org/10.3928/00989134-20240313-01","url":null,"abstract":"<section><h3>Purpose:</h3><p>Adult day services (ADS) are a valuable resource for people living with Alzheimer's disease and Alzheimer's disease and related dementias (AD/ADRD) and serve a large population of late-life immigrants, often with limited English proficiency (LEP). This secondary data analysis examined potential disparities in diagnosis, dementia severity, medical complexity, and dementia-related behavioral problems in persons with AD/ADRD with LEP within the ADS setting.</p></section><section><h3>Method:</h3><p>The current study used data from TurboTAR, the electronic health record for ADS in California. Bivariate analyses were conducted to examine differences in clinical management for those with and without LEP.</p></section><section><h3>Results:</h3><p>Of 3,053 participants included in the study, 42.3% had LEP. Participants with LEP had higher rates of emergency department use and medication mismanagement. However, due to non-standard data collection, there was a significant amount of missing data on language preference (38.1%) and race/ethnicity (46.5%). Although these findings suggest LEP may play a role in the clinical management of persons with AD/ADRD in ADS, missing data caused by lack of standardized collection compromise the results.</p></section><section><h3>Conclusion:</h3><p>It is essential to improve data collection practices in ADS on language, race, and ethnicity to help identify health disparities and promote equitable care for marginalized older adults. [<i>Journal of Gerontological Nursing, 50</i>(4), 42–47.]</p></section>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"24 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of Motoric Cognitive Risk Syndrome Among Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis","authors":"Shan Jiang, MM, RN, Ruitong Guan, MPH, RN, Caixia Guo, MSN, RN, Chunyan Wei, MSN, RN","doi":"10.3928/00989134-20240312-01","DOIUrl":"https://doi.org/10.3928/00989134-20240312-01","url":null,"abstract":"<section><h3>Purpose:</h3><p>To systematically review the prevalence of motoric cognitive risk syndrome (MCR) among community-dwelling older adults and provide evidence-based support for policymakers planning health and social care policies.</p></section><section><h3>Method:</h3><p>Web of Science, PubMed, and Cochrane Library databases were searched for cross-sectional, prospective cohort, or population-based longitudinal studies of community-dwelling older adults aged ≥60 years with MCR from inception of the database through December 18, 2021.</p></section><section><h3>Results:</h3><p>Seventeen studies were included. Pooled prevalence of MCR was found to be 10% (95% confidence interval [8%, 12%], I<sup>2</sup> = 98.4%). Results of a subgroup analysis revealed a combined prevalence of MCR of 8.2% in males and 9.2% in females. Pooled prevalence of MCR was 9.7% in Asia and 10.2% in other regions.</p></section><section><h3>Conclusion:</h3><p>Prevalence of MCR in community-dwelling older adults is high. Our research may improve the epidemiological understanding of MCR, draw attention to older adults with MCR, and thus promote research of MCR and the formulation of relevant public health policies. With early identification and intervention of MCR, cognitive function can be improved, and the onset of dementia can be delayed or prevented. [<i>Journal of Gerontological Nursing, 50</i>(4), 16–24.]</p></section>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"6 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sara K. Mamo, AuD, PhD, Kara A. Wheeler, AuD, Katherine Garrity, BS
{"title":"Virtual Staff Training to Support Communication for Older Adults With Untreated Hearing Loss in Care Settings","authors":"Sara K. Mamo, AuD, PhD, Kara A. Wheeler, AuD, Katherine Garrity, BS","doi":"10.3928/00989134-20240313-02","DOIUrl":"https://doi.org/10.3928/00989134-20240313-02","url":null,"abstract":"<section><h3>Purpose:</h3><p>The current quasi-experimental study aimed to develop and evaluate a virtual staff training on age-related hearing loss at a care organization for older adults.</p></section><section><h3>Method:</h3><p>Training included the use of affordable headset amplifiers and a hands-on activity in which hearing loss was simulated. Staff were encouraged to offer amplifiers to assist in communication given the high prevalence of untreated hearing loss among older adults and the increased communication difficulty that results from mask-wearing.</p></section><section><h3>Results:</h3><p>Quantitative results (<i>N</i> = 51) from the pre/post questionnaire suggest that staff members gained knowledge about hearing loss and communication through the training session. Qualitative data over the 6-month post training suggest that some older adults had not only improved speech understanding but also improved quality of interactions with staff. The main reasons for not using the amplifiers were that staff would forget they had access to the amplifiers or the older adult would refuse to use the device.</p></section><section><h3>Conclusion:</h3><p>This article highlights successes of the training as well as ideas for future trainings suggested by staff members. A key finding was the need to identify a core group of staff members who would be charged with facilitating use of personal amplification for older adults in the organization. In addition, providing multiple brief trainings over time was suggested to improve adoption of good communication practices among staff. [<i>Journal of Gerontological Nursing, 50</i>(4), 48–56.]</p></section>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"44 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mark Toles, PhD, RN, Cameron Ulmer, BSN, RN, Jennifer Leeman, DrPH, MPH, MDiv
{"title":"Health Trajectories of Skilled Nursing Facility Patients With Alzheimer's Disease and Related Dementias: Evidence for Practicing Nurses","authors":"Mark Toles, PhD, RN, Cameron Ulmer, BSN, RN, Jennifer Leeman, DrPH, MPH, MDiv","doi":"10.3928/00989134-20240312-03","DOIUrl":"https://doi.org/10.3928/00989134-20240312-03","url":null,"abstract":"<section><h3>Purpose:</h3><p>Older adults with Alzheimer's disease and related dementias (ADRD) are at high risk for acute medical problems and their health trajectories frequently include hospital admission and care in a skilled nursing facility (SNF). Their health trajectories after SNF discharge are poorly understood. Therefore, in the current study, we sought to describe health trajectories and factors associated with hospital read-missions for older adults with ADRD during the 30 days following SNF discharge.</p></section><section><h3>Method:</h3><p>We conducted a secondary analysis of data from a clinical trial of transitional care of older adults with transitions from SNF to home and assisted living. A multiple case study design was used in the analysis of the health trajectories of 49 SNF patients with ADRD, 51% discharged from SNF to their own home, 34% discharged to a family member's home, and 15% transferred to assisted living.</p></section><section><h3>Results:</h3><p>Within 30 days of discharge, 20% of patients with ADRD experienced new or recurrent acute needs and hospital readmission.</p></section><section><h3>Conclusion:</h3><p>Our findings suggest the need for nursing interventions to support patients with ADRD during care transitions, such as focusing care on the patient–caregiver dyad, providing transitional care, referring patients for palliative care consultation, and conducting nurse-led research to improve care transitions of these patients and their caregivers. [<i>Journal of Gerontological Nursing, 50</i>(4), 34–41.]</p></section>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"52 1","pages":""},"PeriodicalIF":1.3,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140588480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Understanding the Experience of Social Isolation Among Chinese American Older Adults Through a Constructivist Lens.","authors":"Yanjing Liang, Basia Belza, Sarah Iribarren","doi":"10.3928/00989134-20240207-01","DOIUrl":"10.3928/00989134-20240207-01","url":null,"abstract":"","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"50 3","pages":"3-5"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"AGS' Response to the World Falls Guidelines.","authors":"Donna M Fick","doi":"10.3928/00989134-20240208-04","DOIUrl":"10.3928/00989134-20240208-04","url":null,"abstract":"","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"50 3","pages":"51-52"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mary E Kantz, Comfort Enah, Lisa M Abdallah, Ainat Koren
{"title":"Housing and Health in Older Adults With Low Income in the United States: An Integrative Review.","authors":"Mary E Kantz, Comfort Enah, Lisa M Abdallah, Ainat Koren","doi":"10.3928/00989134-20240208-01","DOIUrl":"10.3928/00989134-20240208-01","url":null,"abstract":"<p><strong>Purpose: </strong>The current integrative review was conducted to understand the relationship between housing and health in older adults with low income in the United States.</p><p><strong>Method: </strong>A literature search yielded 20 articles that met inclusion criteria. Key data elements were extracted from each article and a five-level social ecological model (SEM) was used as a framework to analyze the findings.</p><p><strong>Results: </strong>The analysis yielded themes associated with each SEM level: <i>Interaction Between Housing and Personal Traits and Behaviors</i> (individual level); <i>Burdens and Benefits of Social Relationships</i> (relational Level); <i>Building Quality and Health</i> (environmental level); <i>Role of Housing Assistance</i> (structural level); and <i>Influence of Poverty and Structural and Systemic Racism</i> (superstructural level).</p><p><strong>Conclusion/implications: </strong>Results clarify housing's role as a social determinant of health affecting older adults with low income and may help nurses tailor patient assessments and treatment plans to better identify and address housing-related health risks. [<i>Journal of Gerontological Nursing, 50</i>(3), 25-32.].</p>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"50 3","pages":"25-32"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Morgan A Gerber, Michael K Burke, Michael R Brodeur
{"title":"Respiratory Syncytial Virus Vaccination in Older Adults: Considerations for Use and Shared Clinical Decision-Making.","authors":"Morgan A Gerber, Michael K Burke, Michael R Brodeur","doi":"10.3928/00989134-20240207-02","DOIUrl":"10.3928/00989134-20240207-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the impact of two newly U.S. Food and Drug Administration-approved respiratory syncytial virus (RSV) vaccines, RSVpreF3 (Arexvy™, GSK) and RSVpreF (Abrysvo™, Pfizer), on morbidity in older adults. RSV is known to cause significant health issues in this demographic.</p><p><strong>Method: </strong>The current article reviews Phases 1 and 2 and Phase 3 published clinical trials, the recommendations for immunization practices outlined in the <i>Morbidity and Mortality Weekly Report</i>, and other relevant literature on RSV infection and vaccine coadministration. A case vignette is also included to illustrate an example of the shared clinical decision-making process for vaccination.</p><p><strong>Results: </strong>Findings suggest that RSVpreF3 and RSVpreF vaccines effectively reduce health complications of RSV in older adults. Successful integration of these vaccines with other immunizations is also highlighted, emphasizing the role of an interprofessional team in this process.</p><p><strong>Conclusion: </strong>The introduction of RSVpreF3 and RSVpreF vaccines represents a significant advancement in the management of RSV in older adults. This article underscores the importance of shared clinical decision-making in vaccine administration and the effective coordination of an interprofessional team for coadministration with other vaccines. [<i>Journal of Gerontological Nursing, 50</i>(3), 7-12.].</p>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"50 3","pages":"7-12"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nirmala Lekhak, Tirth Bhatta, Eva Kahana, Cecilia Fernandes, Joel S Snyder
{"title":"Meditation, Compassionate Love, and Mental Health in Later Life.","authors":"Nirmala Lekhak, Tirth Bhatta, Eva Kahana, Cecilia Fernandes, Joel S Snyder","doi":"10.3928/00989134-20240208-03","DOIUrl":"10.3928/00989134-20240208-03","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding of the mechanisms by which meditation imparts beneficial effects on later-life mental health is limited. The current study assessed the role of compassionate love in mediating the relationship between meditation and mental health in later life.</p><p><strong>Method: </strong>Using data from a nationwide web-based survey (<i>N</i> = 1,861), we examined the indirect effects of meditation on depressive symptoms and anxiety via compassionate love.</p><p><strong>Results: </strong>Participants who practiced meditation (compared to those who did not) had significantly higher feelings of being loved (<i>b</i> = 0.11, <i>p</i> < 0.05); those who experienced more love had lower depressive symptoms (<i>b</i> = -2.10, <i>p</i> < 0.001) and anxiety (<i>b</i> = -0.99, <i>p</i> < 0.001). Meditation also had significant indirect effects (via compassionate love) on depressive symptoms (<i>b</i> = -0.23, <i>p</i> < 0.05) and anxiety (<i>b</i> = -0.11, <i>p</i> < 0.05).</p><p><strong>Conclusion: </strong>This study underscores the need for contemplative interventions that foster compassionate love to improve mental health in later life. [<i>Journal of Gerontological Nursing, 50</i>(3), 40-50.].</p>","PeriodicalId":15848,"journal":{"name":"Journal of gerontological nursing","volume":"50 3","pages":"40-50"},"PeriodicalIF":1.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139990249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}