Nursing Older People[JOURNAL]
Sun
200 papers
Understanding and managing depression in older people.
Knight J
Nurs Older People · 2019 Nov · PMID 31576729 · Publisher ↗
Clinicians do not always recognise depression in older people as they attribute symptoms to the ageing process and the effects of failing health. Similarly, older people do not always appreciate that their symptoms relat...
Clinicians do not always recognise depression in older people as they attribute symptoms to the ageing process and the effects of failing health. Similarly, older people do not always appreciate that their symptoms relate to their mood. Understanding how depression affects older people can improve access to support, thereby improving overall health and quality of life. To ensure these outcomes we need a workforce with excellent communication skills that supports therapeutic relationships, promotes recognition of symptoms, and enhances assessment, diagnosis, treatment and management.
Assessment and provision of continuing healthcare: an integrative literature review.
Lee G, Hayes N
Nurs Older People · 2019 Sep · PMID 31512845 · Publisher ↗
NHS continuing healthcare is a package of care that is arranged and funded solely by the NHS where an individual has been found to have a 'primary health need'. Individuals who may be eligible have a right to be assessed...
NHS continuing healthcare is a package of care that is arranged and funded solely by the NHS where an individual has been found to have a 'primary health need'. Individuals who may be eligible have a right to be assessed for NHS continuing healthcare, and this assessment is undertaken by healthcare professionals using a national framework. However, there is a lack of literature on continuing healthcare and its assessment process. The aim was to review the literature on undertaking and providing continuing healthcare in terms of workforce roles, education and training, and competencies. A literature search was undertaken to identify relevant literature on continuing healthcare. Primary searching of electronic internal databases and indices at the Royal College of Nursing and King's College London was used, alongside a further database search and hand searching. A narrative synthesis of the literature was used to synthesise the findings, and a thematic analysis was undertaken to identify themes from the literature. The literature search identified 100 articles, of which 84 were excluded because they did not meet the inclusion criteria or provided insufficient details in the abstract. A total of 18 articles were included and examined in detail. Four themes were identified in the literature: complexity of care in transitioning care from hospital to home; different care models; importance of education of healthcare professionals; and role of continuing healthcare. Healthcare professionals - including nurses - should receive further training in caring for older people, especially in relation to continuing healthcare. Since there is an increasing ageing population, there is an increasing requirement for continuing healthcare, and thus further research examining all aspects of this care is required.
How nurses can support informal carers of people living with dementia.
Mashlan W, Ralston S, Jones L
Nurs Older People · 2019 Sep · PMID 31507134 · Publisher ↗
There are 7 million carers in the UK, of whom 11% care for people with dementia. One in five people aged 50-64 are carers. This article explores the difficulties faced by informal carers, and highlights the need to suppo...
There are 7 million carers in the UK, of whom 11% care for people with dementia. One in five people aged 50-64 are carers. This article explores the difficulties faced by informal carers, and highlights the need to support and care for them, as well as the person living with dementia. It suggests how nurses working in hospital settings can recognise and understand the physical and emotional health needs of informal carers through appropriate engagement, assessment and inclusion.
Sexuality and sexual intimacy in later life.
Heath H
Nurs Older People · 2019 Jan · PMID 31468922 · Publisher ↗
Sexuality is as important in older age as it is throughout life, and its expression can be positive, empowering, joyful and life-affirming. The concept of sexuality has many dimensions including identity, need and desire...
Sexuality is as important in older age as it is throughout life, and its expression can be positive, empowering, joyful and life-affirming. The concept of sexuality has many dimensions including identity, need and desire, relationships and behaviour, all of which develop through ageing and life experiences. The evidence on all aspects of sexuality in later life tends to focus on biological dysfunction rather than fulfilment, well-being and quality of life, and does not acknowledge the enormous diversity of older people in terms of age, sexualities, ethnicity and culture. However, the evidence base is growing and, in broad terms, what older people want is becoming more clearly articulated. This article acknowledges the current evidence and, building on this, suggests ways in which nurses working in health and social care services can address some of the challenges, enhance their own understanding and skills, and work creatively with older individuals to offer services that help them to live, and end, their lives according to their individual identities, choices and deepest, most personal, priorities.
Simulation-based training to teach nurses skills in falls assessment and prevention.
Grainger L, Amin K, Watkins D
Nurs Older People · 2019 Jan · PMID 31468921 · Publisher ↗
A simulation-based training course was designed to support the development of nurses' skills in falls assessment and prevention. National guidance on falls risk assessment and prevention was used to develop the course co...
A simulation-based training course was designed to support the development of nurses' skills in falls assessment and prevention. National guidance on falls risk assessment and prevention was used to develop the course content. The course enabled participants to practise real-life scenarios in a safe environment, reflect on their performance and receive feedback from their peers. The post-course evaluations showed positive feedback with all the nurses reporting benefit from this style of learning. They all thought their participation would have a significant effect on their clinical practice and aid their ability to care for patients who had fallen. On an organisational level, the trust has seen an 11% reduction in the number of falls since the training was introduced in 2016.
Living well in older age: what can we learn from the Japanese experience?
Jenkins C, Germaine C
Nurs Older People · 2019 Jan · PMID 31468920 · Publisher ↗
Japan has the most aged population in the world. Not only do people live longer in Japan, they also age better. While the ageing population reflects a success story driven by lifestyle factors and health promotion initia...
Japan has the most aged population in the world. Not only do people live longer in Japan, they also age better. While the ageing population reflects a success story driven by lifestyle factors and health promotion initiatives, it also results in challenges for policymakers, families and older people. Other countries with ageing population profiles, such as the UK, can learn from the Japanese experience. In this article, the authors focus on the potential of health promotion strategies, social connections and technology to enhance well-being in older age.
Practice of Namaste Care for people living with dementia in the UK.
Bray J, Atkinson T, Latham I … +1 more , Brooker D
Nurs Older People · 2019 Jan · PMID 31468919 · Publisher ↗
Originating in the US, Namaste Care aims to improve quality of life for people with advanced dementia. However, recognition in the UK is sparse. This article reports on research that aims to create consistent understandi...
Originating in the US, Namaste Care aims to improve quality of life for people with advanced dementia. However, recognition in the UK is sparse. This article reports on research that aims to create consistent understanding of the purpose, application and effect of Namaste Care. Using an online survey, telephone interviews and discussion group with UK practitioners we explored Namaste Care practice, its components and implementation challenges. Findings show that Namaste Care has potential to improve quality of life in advanced dementia and is held in high regard by practitioners. However, understanding is inconsistent and practical implementation highly varied.
Older people's use of non-pharmacological interventions for chronic, non-cancer pain and comfort.
Shropshire M, Stapleton S, Jin Kim M … +2 more , Dyck M, Mallory C
Nurs Older People · 2019 Nov · PMID 31468910 · Publisher ↗
BACKGROUND: Many older people experience chronic pain, so increased comfort and pain relief are important for older residents in assisted and/or supported-living environments. While several studies have found that people...
BACKGROUND: Many older people experience chronic pain, so increased comfort and pain relief are important for older residents in assisted and/or supported-living environments. While several studies have found that people using non-pharmacological interventions without taking pain medication experienced significant differences in pain, the effect of non-pharmacological interventions on comfort and chronic pain in older people has not been studied. AIM: To assess differences in comfort and pain among older people in assisted and supported-living facilities who had chronic, non-cancer pain and who used or did not use non-pharmacological interventions. METHOD: A descriptive, comparative, cross-sectional pilot study with a convenience sample of 82 participants from 11 assisted and supported-living facilities. Three questionnaires were used to obtain data on the independent variable of use/non-use of non-pharmacological interventions and the dependent variables of perceived comfort and pain. Multivariate analyses of variance were computed to measure differences between the use/non-use groups, and Roy-Bargmann stepdown analyses were computed to further subdivide and analyse the groups who were using and not using pain medication. RESULTS: No significant differences were found in chronic pain and perceived comfort between participants who did or did not use non-pharmacological interventions if they were not also taking pain medication. However, when participants were also taking pain medication, chronic pain and perceived comfort scores were significantly affected by the use of non-pharmacological interventions. The most common non-pharmacological interventions were exercise, heat therapy, spiritual activity/religion and listening to music. CONCLUSION: Older people using non-pharmacological interventions and taking pain medication had higher perceived comfort scores and lower pain scores than those using pain medication only. Relationships between non-pharmacological interventions and comfort should be explored further. With minor changes, this pilot study design could be used with a larger sample.
Helping people live with chronic obstructive pulmonary disease.
Scullion J, Holmes S
Nurs Older People · 2019 Sep · PMID 31468908 · Publisher ↗
Chronic obstructive pulmonary disease (COPD) is a long-term condition characterised by persistent respiratory symptoms and airflow limitation. It is preventable and treatable, but still results in high levels of morbidit...
Chronic obstructive pulmonary disease (COPD) is a long-term condition characterised by persistent respiratory symptoms and airflow limitation. It is preventable and treatable, but still results in high levels of morbidity and mortality. This affects health service costs, but more importantly it affects the person with COPD, and their relatives and carers. If healthcare services continue to focus on managing the disease process rather than the person living with the disease itself, they may continue to produce the same outcomes and fail to substantially reduce the burden of the disease. Helping people live with COPD requires clinicians to communicate effectively with people, families and carers and share multidisciplinary team decisions with patients. Clinicians must consider the physical, psychological, social and spiritual implications of the disease. This article explores how nurses can have a positive effect on the lives of people with COPD, and provides practical strategies and suggestions on giving them effective support.
A professional development programme for care home nurses in east London.
Wasike M, Hamilton R, Sharpe D
Nurs Older People · 2019 Jul · PMID 31468876 · Publisher ↗
There is a need for professional development opportunities for registered nurses undertaking leadership roles in care homes. This article examines the learning outcomes from a pilot career development programme for care...
There is a need for professional development opportunities for registered nurses undertaking leadership roles in care homes. This article examines the learning outcomes from a pilot career development programme for care home nurses, which was designed and delivered as part of a Florence Nightingale Foundation leadership scholarship. The six-month programme, consisting of one-day workshops, focused on four key competencies, one of which was to identify and consider potential pathways for career development in the sector. Fifteen nurses took part in the development programme. They contributed to the session discussions and activities by drawing on their professional experience. On completion, the nurses reported that they believed attending the programme would improve their practice and contribute towards any future career development. The findings indicate an increased confidence among some of the nurses who attended. The programme also had a positive effect on their professional self-image, with some reporting that it made them feel more like 'real nurses', who are proud to care for a vulnerable group in society.
Cognitive assessment using face-to-face and videoconferencing methods.
Stead A, Vinson M
Nurs Older People · 2019 Sep · PMID 31468871 · Publisher ↗
BACKGROUND: Early and regular assessment is needed to identify cognitive impairment in older adults. The use of telehealth or telecognitive assessment is widely applied in some aspects of health services, but it is uncle...
BACKGROUND: Early and regular assessment is needed to identify cognitive impairment in older adults. The use of telehealth or telecognitive assessment is widely applied in some aspects of health services, but it is unclear if cognitive assessments conducted in this way are reliable. AIM: To examine whether using a handheld device to complete a cognitive assessment in adults can provide reliable scores, whether participants would be satisfied to complete a cognitive assessment by videoconference and if they would prefer face-to-face or telehealth assessment, and what challenges might be associated with telecognitive assessment using a handheld device compared with using face-to-face methods. METHOD: Participants ( n =27) were given a series of cognitive assessments face to face and using a handheld device. Results were examined for reliability, logistical and technical challenges, and participants were questioned about which they preferred. RESULTS: Cognitive assessments made with the handheld device were effective and reliable, and produced results that were comparable to those made with face-to-face assessments. However, more participants preferred face-to-face assessments than handheld device assessments. Several technical limitations were also noted during the assessments made using the handheld devices. CONCLUSION: Although scores made using the handheld device were reliable, preliminary evidence suggests there are some tangible barriers to integrating telehealth into all settings for all patients.
Nutritional interventions for preventing malnutrition in people with dementia.
Jones S
Nurs Older People · 2019 Jul · PMID 31468856 · Publisher ↗
Dementia is a progressive, chronic condition affecting cognitive functioning and is most prevalent in people aged over 65. Weight loss, malnutrition and dehydration are common in people living with dementia and can occur...
Dementia is a progressive, chronic condition affecting cognitive functioning and is most prevalent in people aged over 65. Weight loss, malnutrition and dehydration are common in people living with dementia and can occur at any stage of the condition. Malnutrition can have devastating consequences on quality of life and clinical outcomes and significantly increases the risk of morbidity and mortality. Dementia affects a person's ability and desire to eat and drink to meet their nutritional requirements. This article identifies problems associated with nutritional status in people living with dementia and outlines the effectiveness of interventions to counteract the negative effects on nutritional status.
How healthcare professionals can support older LGBTQ+ people living with dementia.
Harper P
Nurs Older People · 2019 Sep · PMID 31468853 · Publisher ↗
Older lesbian, gay, bisexual, trans, queer and others (LGBTQ+) people living with dementia have specific needs related to their sexual orientation and identity that should be addressed to maintain their personhood. They...
Older lesbian, gay, bisexual, trans, queer and others (LGBTQ+) people living with dementia have specific needs related to their sexual orientation and identity that should be addressed to maintain their personhood. They may face challenges in health and social care settings, such as heteronormativity and lack of awareness of older LGBTQ+ needs. Service provision for older LGBTQ+ people with dementia is lacking. Healthcare professionals' attitudes towards older LGBTQ+ people with dementia are often poor and there is a clear need for better training, while increased knowledge and awareness would help to challenge the concept of heteronormativity. This article explores some of the needs of older LGBTQ+ people with dementia, the role of legislation and regulation and how healthcare professionals can provide support.
How healthcare professionals in acute settings construct identities for people with dementia.
Quirke O, Evans W, Brosnan M
Nurs Older People · 2019 Feb · PMID 31468798 · Publisher ↗
BACKGROUND: Healthcare professionals working in acute settings lack education and training in dementia care, resulting in people living with dementia receiving a reduced quality of care. Discourses are ways of communicat...
BACKGROUND: Healthcare professionals working in acute settings lack education and training in dementia care, resulting in people living with dementia receiving a reduced quality of care. Discourses are ways of communicating through written and spoken language, and healthcare professionals often adopt ageist discourses when constructing the identities of people living with dementia. AIM: To explore how healthcare professionals working in acute settings construct the identities of people living with dementia. METHOD: Semi-structured interviews were conducted with nine participants working in acute settings in the Republic of Ireland. FINDINGS: Participants adopted two main discourse areas to construct the identities of people with dementia. The first discourse area related to the act of caring and the second discourse area, described as 'identity discourses', centred on the everyday language used by healthcare professionals. While participants strived to be person-centred the culture of acute settings was often task orientated. CONCLUSION: Caring for people with dementia is challenging in the acute healthcare setting. There is a need for ongoing training and effective continuing professional development strategies.
Approaches to managing older people using opiates and their risk of dependence.
Hamilton I, Kaufman G
Nurs Older People · 2019 May · PMID 31468789 · Publisher ↗
There is little doubt that opiates have transformed healthcare, particularly in relation to pain management. However, many patients prescribed this type of drug develop problems such as dependency. Although we do not kno...
There is little doubt that opiates have transformed healthcare, particularly in relation to pain management. However, many patients prescribed this type of drug develop problems such as dependency. Although we do not know how many older people have developed such problems due to opiate use we know that some will. It is important for nurses to understand the context in which opiates are used, as well as the specific needs of older people and how to respond to them.
Using the Relating to Older People Evaluation tool to measure ageism in higher education.
Cronin C, Brooke J
Nurs Older People · 2019 May · PMID 31468788 · Publisher ↗
BACKGROUND: The global population is ageing and this trend is expected to continue. Attitudes towards older people differ worldwide. Ageism is a complex, multifaceted concept that includes attitudes and behaviours. In th...
BACKGROUND: The global population is ageing and this trend is expected to continue. Attitudes towards older people differ worldwide. Ageism is a complex, multifaceted concept that includes attitudes and behaviours. In the UK, ageism and discriminatory practices exist in nursing, and educationalists and clinicians need to address ageist attitudes and promote the care of older people. In nursing there is a lack of synthesised evidence measuring ageism among nursing students. AIM: To explore the use of the Relating to Older People Evaluation (ROPE) questionnaire in different student populations in higher education, including nursing students. METHOD: A systematic search was conducted for articles written in English describing the use of ROPE, published between 2007 and 2017. Six quantitative studies were identified that met the inclusion criteria. Statistical analysis was not possible and a thematic analysis of these studies was completed. FINDINGS: Two themes emerged: attitudes predict behaviour and socialisation to ageism in higher education. Ageist attitudes were correlated with negative ageist behaviours and the socialisation of nursing students in clinical practice increased ageist attitudes. CONCLUSION: Ageism and the ageist attitudes of nursing students must continue to be explored. ROPE is a suitable tool to measure nursing students' ageist attitudes and behaviours.
Development of a capability-based training programme for an advanced nurse practitioner.
Kilgore C
Nurs Older People · 2019 May · PMID 31468787 · Publisher ↗
Although there is a long history of advanced nursing practice in the UK, without registration it is difficult to ensure that all staff who regard themselves as advanced practitioners have the necessary clinical acumen. T...
Although there is a long history of advanced nursing practice in the UK, without registration it is difficult to ensure that all staff who regard themselves as advanced practitioners have the necessary clinical acumen. This article explores how a capability-based training programme was developed for one advanced nurse practitioner (ANP) in the care of older people in a community healthcare NHS trust. It also considers whether the programme could be replicated for other clinicians wishing to train for a specific advanced practice role. The programme was developed as part of a service improvement project and used work-based practice to identify the clinician's learning needs. Various learning tools were used and the trainee ANP recorded their development in a portfolio of work including reflections and clinical summaries. The main direction for learning was through the use of a written programme guide that set out benchmarks to be achieved during the two-year programme. The trainee ANP met the requirements of the programme and was appointed to a senior ANP post at the end of the two years. There is merit in using a standardised capability-based training programme when developing advanced practitioners. Standardisation allows an organisation to ensure that advanced practitioners can provide an appropriate level of clinical practice to older patients with complex needs.
Ethical practice in dementia care.
Mitchell V
Nurs Older People · 2019 Mar · PMID 31468783 · Publisher ↗
This article draws on a range of case study examples from dementia care and explains how ethical theory can be applied to enhance professional practice. Ethical concepts are critically examined in this context and tensio...
This article draws on a range of case study examples from dementia care and explains how ethical theory can be applied to enhance professional practice. Ethical concepts are critically examined in this context and tensions between them are explored. The article demonstrates how an established ethical framework can assist with application in practice situations. It also argues that cultivating virtues, such as courage and receptivity, is an essential aspect of providing ethical nursing care for people with dementia.
Attitudes and beliefs of healthcare workers about influenza vaccination.
Halpin C, Reid B
Nurs Older People · 2019 Mar · PMID 31468782 · Publisher ↗
BACKGROUND: Annual influenza vaccination is recommended for all healthcare workers (HCWs) to help reduce the risk of contracting the virus and transmitting it to vulnerable people, especially older adults in residential...
BACKGROUND: Annual influenza vaccination is recommended for all healthcare workers (HCWs) to help reduce the risk of contracting the virus and transmitting it to vulnerable people, especially older adults in residential care facilities. Vaccination uptake among HCWs remains low. AIM: To investigate HCWs' attitudes towards, and beliefs about, seasonal influenza vaccination in a residential care facility for older adults in the Republic of Ireland. METHOD: Data were collected using a self-administered questionnaire. RESULTS: A total of 95 questionnaires were distributed, and 35 (37%) HCWs completed and returned them. During the 2016-17 flu season, 20 (57%) respondents were vaccinated. Primary predictors of vaccination acceptance were the belief that being healthy should not mitigate against requiring the vaccine ( r =0.7, P =0.01), protection of self and family ( r =0.67, P =0.01), protection of patients ( r =0.592, P =0.01) and agreement with mandatory vaccination ( r =0.351, P =0.039). Reasons for vaccination avoidance were misconceptions about the need for vaccination among healthy HCWs (67%), efficacy of the vaccine (60%), lack of trust in the vaccine (47%) and a belief that the vaccine may cause flu (47%). CONCLUSION: Addressing HCWs' beliefs relating to the personal benefits of vaccination while simultaneously correcting misconceptions may help to increase uptake among those working in residential care settings for older adults.
Cognitive decline: can diet be a preventive or treatment option?
Davies R
Nurs Older People · 2019 Mar · PMID 31468781 · Publisher ↗
Cognitive decline has been associated with and accepted as a consequence of ageing. Diets such as the Mediterranean diet have been investigated for their effect on abating cognitive decline. However, diet is not the only...
Cognitive decline has been associated with and accepted as a consequence of ageing. Diets such as the Mediterranean diet have been investigated for their effect on abating cognitive decline. However, diet is not the only aspect of the Mediterranean life that may play a role - social interaction and cultural engagement may also be influential in preserving cognitive function through the ageing process. This article discusses the perspective on cognitive decline and the influence the Mediterranean diet may have. It highlights that no sole dietary regimen will prevent cognitive decline and the UK healthy eating guidelines reflect those foods included in the Mediterranean diet. The focus should instead be on the way in which people engage with food, society and culture to maintain a healthy body and mind.
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