{"title":"Implementing palliative and end of life care for people with dementia.","authors":"Diane Drain, Louisa Stone, Rachel Louise Daly","doi":"10.7748/nop.2024.e1479","DOIUrl":"https://doi.org/10.7748/nop.2024.e1479","url":null,"abstract":"<p><p>Dementia is characterised by memory loss, behavioural changes and decline of cognitive, social and physical functions and is a life-limiting condition. At the point of diagnosis it is classed as a palliative condition, yet there is limited public and healthcare professional awareness that, once diagnosed, a person will either die of dementia or die with dementia. This article discusses how the recognition and timing of the need for palliative dementia care is pivotal in providing person-centred care. The authors explore factors such as optimal prognostication, advance care planning, staff education and accessing support from palliative and end of life care teams and Admiral Nurses. The authors also use a fictional case study to demonstrate best practice in palliative dementia care.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring the feasibility of using a bedside device to help prevent nighttime falls.","authors":"Kevin Edward Anthony, Laura Houten, Pip Logan","doi":"10.7748/nop.2024.e1484","DOIUrl":"https://doi.org/10.7748/nop.2024.e1484","url":null,"abstract":"<p><strong>Background: </strong>Older people living in the community are at risk of preventable nighttime falls. Technology can support falls interventions but there is a lack of research into this area. A new bedside device called Bide senses movement and changes in light levels and plays a prerecorded message encouraging the user to follow falls prevention advice when trying to mobilise at night.</p><p><strong>Aim: </strong>To test the feasibility of using the Bide device in a community health service.</p><p><strong>Method: </strong>Healthcare workers were trained in the use of the Bide device and asked to identify potential participants. The research team subsequently recruited participants, provided them with a device and explained how to use it. After four weeks, participants took part in face-to-face semi-structured interviews regarding the acceptability of the device. Participants' fear of falling was calculated before and after the intervention using the Falls Efficacy Scale-International.</p><p><strong>Findings: </strong>The Bide device appeared to increase patients' confidence to mobilise at night and no adverse events were reported from its use. The device was generally found to be acceptable and easy to use, although one participant found it irritating. Healthcare workers flagged up very few potential participants to the research team, which may have been due to workload pressures and a disconnect between healthcare workers and technology.</p><p><strong>Conclusion: </strong>It appears feasible to study the use of the Bide device for nighttime falls prevention in the community. To enhance recruitment, a member of the research team may be embedded in the clinical team with the aim of proactively identifying potential participants.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142515563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Implementing the PURPOSE T pressure ulcer risk assessment tool into clinical practice.","authors":"Julie Tyrer","doi":"10.7748/nop.2024.e1489","DOIUrl":"https://doi.org/10.7748/nop.2024.e1489","url":null,"abstract":"<p><p>The first intervention in pressure ulcer prevention is often the completion of a pressure ulcer risk assessment, which aims to identify a patient's level of risk of developing a pressure ulcer. Appropriate care planning should then follow. There are several pressure ulcer risk assessment tools that nurses can use in their clinical practice, but it has not always been clear which is the most effective. One of these tools - the PURPOSE T (Pressure Ulcer Risk Primary or Secondary Evaluation Tool) - has recently been recommended in national guidelines and is now considered to be the only tool with an up-to-date evidence base. This article examines some of the risk assessment tools used to assess pressure ulcer risk, as well as providing an overview of the PURPOSE T and explaining its significance in pressure ulcer prevention.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142362623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nursing older peoplePub Date : 2024-09-30Epub Date: 2024-06-12DOI: 10.7748/nop.2024.e1465
Gayle Madden, Beth Goss-Hill
{"title":"Using critical reflection to enhance the care of older people: a practice example.","authors":"Gayle Madden, Beth Goss-Hill","doi":"10.7748/nop.2024.e1465","DOIUrl":"10.7748/nop.2024.e1465","url":null,"abstract":"<p><p>Reflection is an essential aspect of nursing practice that facilitates continuing professional development and practice improvement. Critical reflection is a more in-depth form of reflection and can be described as a creative, dynamic and transformative learning process that enhances practice by promoting self-awareness and critical thinking. Older adults often present with complex and multiple healthcare needs. Engaging in critical reflection can assist nurses to provide the high-quality, person-centred care required to meet those needs, support older people to retain their independence and enhance their well-being. This article discusses critical reflection within the context of nursing older people and describes various models that can be used to support the reflective process. The authors use a practice example to illustrate how using critical reflection in practice can enable nurses to develop a deeper understanding of themselves and use what they have learned to enhance their delivery of person-centred care.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141307718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nursing older peoplePub Date : 2024-09-30Epub Date: 2024-07-17DOI: 10.7748/nop.2024.e1466
Qun Wang
{"title":"Assessing pain in older people with normal, mildly impaired or severely impaired cognition.","authors":"Qun Wang","doi":"10.7748/nop.2024.e1466","DOIUrl":"10.7748/nop.2024.e1466","url":null,"abstract":"<p><p>Pain is a relatively common experience among older people, but unrelieved pain has significant functional, cognitive and emotional consequences for this population. A comprehensive and accurate pain assessment is essential for effective pain management. Self-report tools are suitable to assess pain in older people with normal or mildly impaired cognition, while observational tools are suitable for use with those with significant cognitive impairment or communication difficulties. However, pain assessment in older people can be challenging. The use of one tool on its own is rarely sufficient and it is crucial to involve family carers in assessment of pain in older people with severe cognitive impairment. This article discusses different tools and strategies, including the benefits and limitations, for assessing pain in older people.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":"35-42"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141629665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nursing older peoplePub Date : 2024-09-30Epub Date: 2024-06-26DOI: 10.7748/nop.2024.e1462
Kimberly LeBlanc, Karen Ousey
{"title":"Assessment, prevention and management of skin tears in older people.","authors":"Kimberly LeBlanc, Karen Ousey","doi":"10.7748/nop.2024.e1462","DOIUrl":"10.7748/nop.2024.e1462","url":null,"abstract":"<p><p>Skin tears are common injuries that result from mechanical forces. Older people with fragile skin are at greater risk of this type of wound. They are usually categorised as acute wounds that typically heal in 7-21 days but the healing process can be disrupted, leading to chronic, non-healing wounds. They have the potential to compromise quality of life and disrupt daily activities, so it is important to identify risk factors and implement prevention strategies for those at risk. An interdisciplinary approach has a pivotal role in promptly and precisely identifying skin tears, and the use of evidence-based interventions for efficient skin damage management can enhance the recovery process. This article adopts a case study approach to explore the prevention, evaluation and treatment of skin tears, using the case of an individual living with a skin tear in a community setting.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":"22-28"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Exploring research participation in Scottish care homes since the COVID-19 pandemic.","authors":"Emma Law, Rosalie Ashworth, Susan Shenkin","doi":"10.7748/nop.2024.e1485","DOIUrl":"https://doi.org/10.7748/nop.2024.e1485","url":null,"abstract":"<p><p>Knowledge about research participation in care homes is sparse. To explore research participation in Scottish care homes, including the potential barriers and facilitators, a short survey was distributed to all care homes in Scotland in 2014. The survey was repeated in 2022 as care homes emerged from the effects of the coronavirus disease 2019 (COVID-19) pandemic. This article provides a comparison of the results of the 2022 survey (45 responses) with those of the 2014 survey (130 responses); the surveys were completed by care home staff. The results indicate that there has been a slight increase in the proportion of care homes involved in research in the intervening period but overall, research participation has remained low in this sector. In the 2022 survey, the main factors identified as influencing a resident's decision to participate in research were 'to help others', 'to benefit the resident' and the 'resident's desire to participate'. The main obstacles to research participation by staff and/or residents were workload pressure and lack of time, which had increased significantly since the 2014 survey. The results reinforce the importance of ensuring care home staff feel equipped to participate in research.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335392","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to optimise medicines management for people with Parkinson's disease in hospital.","authors":"Cindy Marguerite Cox","doi":"10.7748/nop.2024.e1480","DOIUrl":"https://doi.org/10.7748/nop.2024.e1480","url":null,"abstract":"<p><strong>Rationale and key points: </strong>Hospital admissions can be challenging for people with Parkinson's disease, in part because of the lack of understanding, among some healthcare professionals, of the importance of administering antiparkinsonian medicines on time. This article outlines the steps that nurses can take to optimise medicines management for people with Parkinson's disease who are admitted to hospital. • Pharmacotherapy is the primary treatment for Parkinson's disease and aims to increase dopamine levels in the brain to relieve symptoms. • People with Parkinson's disease require careful administration, titration, adjustment and monitoring of their antiparkinsonian medicines regimen, which is highly individualised. • It is crucial that people with Parkinson's disease take their antiparkinsonian medicines at exactly the right time, since the inaccurate timing of these medicines can have significant adverse health implications. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking medicines management for people with Parkinson's disease in hospital. • How you could use this information to educate nursing students or your colleagues on optimising medicines management for people with Parkinson's disease in hospital.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Natasha Alvarado, Lynn McVey, Nick Hardiker, Hadar Zaman, Dawn Dowding, Peter Gardner, Frances Healey, Rebecca Randell
{"title":"Strategies used by nurse leaders to support the delivery of falls prevention practices in hospitals.","authors":"Natasha Alvarado, Lynn McVey, Nick Hardiker, Hadar Zaman, Dawn Dowding, Peter Gardner, Frances Healey, Rebecca Randell","doi":"10.7748/nop.2024.e1478","DOIUrl":"https://doi.org/10.7748/nop.2024.e1478","url":null,"abstract":"<p><p>Despite prevention efforts, falls in hospital are a common and ongoing safety concern, with older people more likely to fall and experience harm as a result of falls. Clinical guidelines recommend multifactorial falls risk assessment and multidomain, personalised interventions to reduce falls risks in hospitals. This article reflects on findings from a multi-site study on the implementation of multifactorial falls prevention practices that informed the development of actionable guidance. The discussion focuses on strategies used by nurse leaders, at different levels of seniority, that shaped practice on orthopaedic and older person wards. While falls risk assessment documentation was monitored routinely by senior leaders, in practice falls prevention often relied on risk screening and enhanced patient supervision. Findings suggest that nurses need to be empowered to lead practices that modify and mitigate individual falls risks where possible, with greater multidisciplinary and patient and carer involvement.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142010170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"How to undertake a holistic nutritional assessment with older people.","authors":"Sharon Waight, Michele Board","doi":"10.7748/nop.2024.e1481","DOIUrl":"https://doi.org/10.7748/nop.2024.e1481","url":null,"abstract":"<p><strong>Rationale and key points: </strong>Nutrition is a fundamental aspect of nursing care, however older people cared for in hospital, in a care home or in their own home do not always receive adequate support with their nutritional needs, which can leave them at risk of malnutrition. Using a holistic, biopsychosocial framework to support a comprehensive nutritional assessment that includes malnutrition screening can support the nurse to identify the older person's nutritional status and nutrition needs. Nurses undertaking this procedure must ensure they have the knowledge and skills to do so and work within the limits of their competence. • Malnutrition in older people can lead to a decline in functional ability, reduced muscle strength, fatigue, impaired immunity, suboptimal wound healing, increased risk of infection and increased risk of falls. • Screening for, and assessing the risk of, malnutrition is an important part of nursing assessments in any healthcare setting. • A holistic nutritional assessment should incorporate physiological, psychological, emotional, spiritual, social and cultural elements. REFLECTIVE ACTIVITY: ' How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking a holistic nutritional assessment with an older person. • How you could use this information to educate nursing students or your colleagues on the appropriate techniques and evidence base for undertaking a holistic nutritional assessment with an older person.</p>","PeriodicalId":94162,"journal":{"name":"Nursing older people","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141899289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}