Nurs Older People
· 2022 Feb · PMID 35018750
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Empathy is an integral aspect of communication with older people and is central to person-centred care. As part of the provision of person-centred care, empathy supports effective communication, producing positive effect...Empathy is an integral aspect of communication with older people and is central to person-centred care. As part of the provision of person-centred care, empathy supports effective communication, producing positive effects such as increased emotional well-being, increased adherence to treatment plans, reduced pain levels and improved wound healing. Empathy involves attempting to understand the other person's perspective and feelings and communicate that understanding back to them. Empathic communication can help older people feel that they are being listened to and valued as partners in healthcare relationships. This article focuses on why it is important to demonstrate empathy when communicating with older people and how this can be achieved. It explains the origin of the concept of empathy in nursing and provides different ways of characterising empathy. It explores barriers to empathic communication in older people nursing and identifies verbal and non-verbal communication skills that nurses can use to enhance their empathy. Finally, it explains the importance for nurses to develop self-awareness and undertake self-care to preserve their capacity to demonstrate empathy towards older people.
Jones S, Archer E, Ongan D
… +5 more, Morais C, Speer R, Tsagari A, Jager-Wittenaar H, Ruperto M
Nurs Older People
· 2021 Dec · PMID 34877834
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Older people are a high-risk group for coronavirus disease 2019 (COVID-19) because of a range of factors, including age-related changes in anatomical pulmonary and muscle function, decreased immunity and increased inflam...Older people are a high-risk group for coronavirus disease 2019 (COVID-19) because of a range of factors, including age-related changes in anatomical pulmonary and muscle function, decreased immunity and increased inflammation. These factors partly explain why older people with COVID-19 experience more severe symptoms and higher mortality than younger adults and are more likely to require nutritional support. Furthermore, there is an association between suboptimal nutritional status and poorer recovery from COVID-19. Therefore, nutritional interventions are an important aspect of care for older people with COVID-19. All members of the multidisciplinary team, including dietitians and nurses, need to assess, treat and prevent nutritional deficiencies in older people with COVID-19. This literature review provides an overview of the evidence regarding the role of nutritional interventions in the treatment of, and recovery from, COVID-19 in older people.
Nurs Older People
· 2022 Feb · PMID 34816648
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Although person-centred care represents the gold standard of nursing practice, there are still instances of care that fail to recognise patients as individuals. Person-centred care depends on the nurse's knowledge of the...Although person-centred care represents the gold standard of nursing practice, there are still instances of care that fail to recognise patients as individuals. Person-centred care depends on the nurse's knowledge of the whole person, including their values, beliefs and aspirations. This article describes a quality improvement project that sought to develop patient profiles based on the concept of 'five things about me', thereby contributing to person-centred care for older people on a medical ward. The effect on staff, older people and their families was assessed through questionnaires, and group and individual discussions. During the project period, 37 person-centred profiles were completed from 52 eligible patients. Ward staff reported increased confidence when delivering person-centred care and older people and their family members confirmed improvements in care delivery and strengthened relationships with staff.
Nurs Older People
· 2021 Nov · PMID 34730298
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Anxiety is a debilitating condition that adversely affects people's quality of life. It is challenging to differentiate anxiety from other physical and mental health conditions in older people, particularly those with co...Anxiety is a debilitating condition that adversely affects people's quality of life. It is challenging to differentiate anxiety from other physical and mental health conditions in older people, particularly those with co-morbid dementia or depression. The coronavirus 2019 pandemic has compounded social isolation and loneliness in older people, causing increased levels of anxiety. Nurses need to be able to detect and assess anxiety in older people and offer short, low-intensity interventions to support older people's mental health or refer them to specialist assessment and treatment. While research on anxiety in older people is lacking, cognitive behavioural therapy, mindfulness, yoga, music therapy and pleasant activities have shown potential as non-pharmacological interventions for alleviating anxiety in older people. This article explores the role of nurses in identifying when an older person may be experiencing anxiety and then choosing the optimal non-pharmacological intervention to support them.
Nurs Older People
· 2021 Nov · PMID 34643343
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BACKGROUND: Enjoying cultural events such as musical performances is a human right as well as contributing to quality of life. However, older people who live in nursing homes are often excluded from such events. Music in...BACKGROUND: Enjoying cultural events such as musical performances is a human right as well as contributing to quality of life. However, older people who live in nursing homes are often excluded from such events. Music interventions for older people with cognitive decline have been shown to have a positive effect on their mood and behaviour, particularly in terms of anxiety, agitation and irritability. AIM: To investigate the effect of musical interventions in nursing homes from the perspective of older people, their relatives and caregivers. METHOD: Musical performances were held at 11 nursing homes in Sweden. These performances were followed by semi-structured interviews that aimed to capture the experiences of the older people, their relatives and caregivers. The interviews were analysed by qualitative thematic analysis. FINDINGS: Four relational themes were generated from the analysis: music enhances well-being for the body and soul, music evokes emotions and a 'spark of life', music adds a 'silver lining' to everyday life, and music inspires a journey of the imagination through time and space. CONCLUSION: The music concerts had a positive effect on older people, their relatives and caregivers. Providing cultural encounters in nursing homes is an important caring intervention.
Dementia presents a major public health challenge to healthcare providers globally. When older people with dementia need inpatient mental healthcare, they can be cared for in one of two different types of older adult war...Dementia presents a major public health challenge to healthcare providers globally. When older people with dementia need inpatient mental healthcare, they can be cared for in one of two different types of older adult ward. These patients can either be admitted to an organic inpatient ward for people with dementia or the subtypes of dementia, or they can be admitted to a mixed inpatient ward for older people who have either functional or organic conditions. Using a quality assurance pilot study, the authors aimed to investigate whether the quality of care for patients with dementia differed between mixed and organic inpatient wards in units exclusively serving older people. The quality of care on both types of ward was compared by analysing observed interactions between patients and staff, patient well-being and patient environment and mealtimes. The quality of care was measured with a specially developed instrument and against evidence-based standards of care. The ratings of both types of ward showed high levels of quality interactions between patients and staff. There were minimal differences in the quality of patient and staff interactions, patient well-being, and patient environment and mealtimes between the two types of ward. Further work on outcomes and carer experiences needs to be undertaken to establish the optimal care environment for people with dementia.
Nurs Older People
· 2021 Oct · PMID 34494411
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Lower urinary tract symptoms (LUTS) are prevalent in older women. These symptoms are often under-reported due to the potentially embarrassing nature of the symptoms and a belief that they are an inevitable consequence of...Lower urinary tract symptoms (LUTS) are prevalent in older women. These symptoms are often under-reported due to the potentially embarrassing nature of the symptoms and a belief that they are an inevitable consequence of ageing. LUTS such as urinary incontinence have a significant negative effect on people's quality of life; however, with the appropriate assessment and management, improvements can be achieved. This article reviews the different types of LUTS and their causes, assessment and treatment, focusing on older women. It aims to provide nurses with an understanding of LUTS so that they can identify appropriate interventions.
Nurs Older People
· 2022 Feb · PMID 34431259
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Established in 2019, the Lincolnshire Admiral Nurse Service supports family carers of people living with dementia through psychosocial interventions. Before the coronavirus disease 2019 (COVID-19) pandemic, the team prov...Established in 2019, the Lincolnshire Admiral Nurse Service supports family carers of people living with dementia through psychosocial interventions. Before the coronavirus disease 2019 (COVID-19) pandemic, the team provided home visits as standard, but the fact that Lincolnshire is a large rural county affected the team's ability to provide timely support to all the carers who needed it. In 2019-20, a practice development project underpinned by participatory action research was undertaken to trial the use of video consultations with carers. However, carers' uptake of video consultations was low and the project was affected by the COVID-19 pandemic. This article describes the project and discusses the findings of its evaluation. The Admiral Nurse team had mixed experiences and felt that, overall, its support was more effective when delivered face to face. The project provides insights into the challenges and benefits of video consultations for delivering psychosocial interventions to carers of people living with dementia.
Nurs Older People
· 2021 Nov · PMID 34378369
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Informal caregivers have a vital role in supporting and caring for family members with dementia. Caregiving is complex and may lead to psychological, physical, social and financial stress for caregivers. This article rep...Informal caregivers have a vital role in supporting and caring for family members with dementia. Caregiving is complex and may lead to psychological, physical, social and financial stress for caregivers. This article reports the findings of an integrative review that explored the literature on the psychological effect of caring for a family member with dementia at home. The article discusses four themes that were identified in the literature: 'the world shrinks'; 'surrender to the unknown'; 'robbed of the future'; and 'torn between relief and guilt'. These themes provide insight into the holistic experience of caring for a family member with dementia, revealing the positive and negative psychological effects of the role.
Nurs Older People
· 2021 Nov · PMID 34286521
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Frailty is a syndrome involving increased vulnerability that usually develops from age-related decline in physiological reserves and function in multiple organ systems, resulting in an impaired ability to respond to acut...Frailty is a syndrome involving increased vulnerability that usually develops from age-related decline in physiological reserves and function in multiple organ systems, resulting in an impaired ability to respond to acute changes in health conditions. It is imperative that healthcare providers who work with older adults in primary care and community settings understand how to assess frailty and can identify appropriate interventions. This article reports the results of a rapid review that examined how frailty is assessed in community-dwelling older adults and what interventions are used to address frailty in this population.
Nurs Older People
· 2021 Oct · PMID 34231346
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Optimal sleep is essential for health, well-being and recovery from illness but can be challenging to achieve in the acute hospital setting. Older people with dementia may find it particularly challenging to sleep well i...Optimal sleep is essential for health, well-being and recovery from illness but can be challenging to achieve in the acute hospital setting. Older people with dementia may find it particularly challenging to sleep well in the unfamiliar and disruptive environment of a hospital ward. Suboptimal sleep may potentially accelerate the progression of dementia. Conversely, optimal sleep may slow disease progression. Nursing staff who care for older people with dementia in hospital therefore need to find ways of supporting them to sleep well. This article explores the causes and consequences of suboptimal sleep in hospitalised older people with dementia and discusses evidence-based interventions that nursing staff can use to support these patients to sleep well, including person-centred sleep care, changes to sleep hygiene, environmental adaptations and changes to medicine regimens.
Nurs Older People
· 2021 Oct · PMID 34159765
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The number of older people undergoing surgery in the UK is increasing, partly due to an ageing population and advances in surgical techniques. However, outcomes for older patients who have undergone surgery are suboptima...The number of older people undergoing surgery in the UK is increasing, partly due to an ageing population and advances in surgical techniques. However, outcomes for older patients who have undergone surgery are suboptimal when compared with younger people, especially following emergency surgery. To minimise the risk of adverse events affecting older people following surgery, it is essential that nurses understand how to manage common challenges for this patient group such as delirium, pain, reduced mobility and inadequate hydration.
Nurs Older People
· 2021 Aug · PMID 34105318
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Pressure ulcers are more common in patients being cared for in palliative care settings than in the general population. Patients with life-limiting illnesses are living longer than ever before, and many present with mult...Pressure ulcers are more common in patients being cared for in palliative care settings than in the general population. Patients with life-limiting illnesses are living longer than ever before, and many present with multiple co-morbidities. Palliative care involves improving the patient's quality of life by achieving a balance between treatment, comfort and maintaining dignity. The length of time required to heal pressure ulcers in this patient population can prove challenging, requiring significant resources and expertise. However, when the appropriate nursing expertise and resources are available, prevention, improvement and healing of pressure ulcers are achievable.
Nurs Older People
· 2021 Oct · PMID 34008354
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During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older people were discharged from hospitals to care homes to release NHS beds. This influx of new residents whose COVID-19 status was largely unk...During the first wave of the coronavirus disease 2019 (COVID-19) pandemic, older people were discharged from hospitals to care homes to release NHS beds. This influx of new residents whose COVID-19 status was largely unknown added to the many challenges already experienced by care homes, with serious consequences including an increased number of deaths among residents. The social care sector has been fragile for several years and the pandemic has brought the challenges experienced by care homes to the forefront, prompting renewed calls for improved funding and reform. This article describes the ongoing challenges and additional challenges caused by the pandemic in the care home sector. The authors argue for urgent reform to enhance the status and education of care home staff, move towards registration of the social care workforce in England, and achieve integration of health and social care services for older people.
Nurs Older People
· 2021 Aug · PMID 33949160
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BACKGROUND: An ageing population with a range of co-morbidities means the number of hospital admissions of older people with dementia is increasing. People with dementia can find acute hospital settings unsettling and th...BACKGROUND: An ageing population with a range of co-morbidities means the number of hospital admissions of older people with dementia is increasing. People with dementia can find acute hospital settings unsettling and they need to be cared for by a workforce skilled and knowledgeable in dementia care. AIM: To explore nursing students' experiences of, and socialisation in, dementia care in the acute hospital setting in England through a secondary qualitative analysis of data from a phenomenological study of nursing students' cultural beliefs around, and understanding of, dementia. METHOD: Data from ten focus groups with 81 undergraduate nursing students at two universities in the south of England were subjected to content analysis. This was a secondary qualitative analysis of data retrieved from an earlier study. FINDINGS: Two categories emerged: 'exposure to dementia care' and 'socialisation in dementia care'. Participants often felt unprepared to care for patients with dementia and their experiences were negatively affected by staff's views of patients with dementia, who were often considered challenging to manage. Participants also encountered specialist dementia nurses who enabled them to learn more about person-centred dementia care. CONCLUSION: Optimal dementia care knowledge and skills can contribute to enhanced patient outcomes and positive attitudes towards older people's care. To reduce deficits in dementia care education, nurses need regular continuing professional development in dementia care, higher education institutions need to commit to developing dementia care in their curricula, and students need to be socialised in dementia care earlier during undergraduate nurse education.
Nurs Older People
· 2021 Aug · PMID 33881806
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Parkinson's is a progressive neurological condition characterised by a range of debilitating motor and non-motor symptoms and often leading to the development of Parkinson's dementia. People with Parkinson's need to take...Parkinson's is a progressive neurological condition characterised by a range of debilitating motor and non-motor symptoms and often leading to the development of Parkinson's dementia. People with Parkinson's need to take antiparkinsonian medicines at frequent and regular intervals to control their symptoms. However, concordance with medicines is often suboptimal, with some people taking excessive doses to alleviate their symptoms or forgetting to take their medicines. For people with Parkinson's living at home, monitoring and support from a community Parkinson's nurse specialist (CPNS), in coordination with local services, can assist them in managing their medicines and enable them to remain safely in their own home. This article discusses the case of one patient and the interventions provided to her over a six-month period by the CPNS, alongside the community multidisciplinary team, to improve her medicine concordance and ensure her safety.
Nurs Older People
· 2021 Aug · PMID 33825366
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The COVID-19 pandemic has resulted in an increase in the number of older adults in the community who are at risk of malnutrition. Vulnerable groups include people recovering at home from mild-to-moderate COVID-19, those...The COVID-19 pandemic has resulted in an increase in the number of older adults in the community who are at risk of malnutrition. Vulnerable groups include people recovering at home from mild-to-moderate COVID-19, those discharged from hospital after severe infection and those who have undergone extended periods of social isolation as a result of the public health measures in place to reduce the spread of infection. Various COVID-19-specific malnutrition care pathways and resources are available, and this article details practical interventions that can assist nurses caring for older adults in the community to identify and manage malnutrition risk.
Nurs Older People
· 2021 Jun · PMID 33759404
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Medicines optimisation involves ensuring that medicines are administered safely and effectively. In the UK, an ageing population and an increasing prevalence of polypharmacy mean that interprofessional medicines reviews...Medicines optimisation involves ensuring that medicines are administered safely and effectively. In the UK, an ageing population and an increasing prevalence of polypharmacy mean that interprofessional medicines reviews and medicines optimisation are vital. This article uses a case study of an older person living with frailty to provide a critical analysis of the medicines optimisation process in optimising health outcomes. The case study focuses on the medicines prescribed, the issues that can arise such as polypharmacy, and the benefits of a medicines-optimisation approach.
Nurs Older People
· 2021 Mar · PMID 33655732
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Older people, particularly those in nursing homes, are vulnerable to delirium, which is a condition characterised by confusion. This article outlines the risk factors, prevention, identification and management of deliriu...Older people, particularly those in nursing homes, are vulnerable to delirium, which is a condition characterised by confusion. This article outlines the risk factors, prevention, identification and management of delirium in older people in nursing homes and acute settings. It uses a case study approach to encourage nurses to consider the challenges faced in these settings and how they could address delirium. The article also details the multicomponent interventions that can be used for prevention, as well as the available delirium assessment tools, with a focus on selecting tools based on the person's health status and the healthcare setting.
Nurs Older People
· 2021 Jun · PMID 33624462
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Oral health for older people living in nursing homes has long been an area of interest and concern, with suboptimal oral health often having significant effects on their general health, well-being and quality of life. Th...Oral health for older people living in nursing homes has long been an area of interest and concern, with suboptimal oral health often having significant effects on their general health, well-being and quality of life. This article outlines the reasons why oral health can deteriorate in nursing home residents and the potential effects of this, and provides information about relevant national guidance. The article also details practical recommendations for nursing home staff on improving residents' oral hygiene, including undertaking oral health assessments, delivering mouth care and accessing dental services.