journal
https://read.qxmd.com/read/38504558/risk-management-and-decision-making-in-dementia-care
#1
JOURNAL ARTICLE
Zena Aldridge, Karen Harrison Dening
What constitutes a risk for a person living with dementia may be perceived and prioritised differently by nurses from varying clinical backgrounds. Furthermore, risk may be perceived differently according to the context. This article outlines some of the social, psychological and physical risk factors relevant to people living with dementia across the life course of the condition. It is important that nurses understand their role in identifying, assessing and managing risk and are aware of the resources, policies, legislation and processes designed to support decision-making and minimise the risk of harm to people living with dementia, their families and carers...
March 20, 2024: Nursing Older People
https://read.qxmd.com/read/38444165/using-therapeutic-lies-an-ethical-challenge-for-nurses-when-caring-for-people-with-dementia
#2
JOURNAL ARTICLE
Jane Pritchard
People living with dementia can become vulnerable when experiencing symptoms such as memory loss and disorientation, as well as stigma attached to the condition. The care of people with dementia is fraught with ethical dilemmas and challenges regarding how nurses should respond to situations that put patients at risk of distress. For example, if a person with dementia asks to see a deceased relative, a nurse may have to decide whether to tell the truth, or a 'white lie' to avoid distress. This article examines the debates around the use of such 'therapeutic lying' when caring for people with dementia and provides guidance on how nurses could use this technique while protecting the individual's best interests...
March 6, 2024: Nursing Older People
https://read.qxmd.com/read/38379374/exploring-whether-a-diagnosis-of-severe-frailty-prompts-advance-care-planning-and-end-of-life-care-conversations
#3
JOURNAL ARTICLE
Stacey Dodson
BACKGROUND: Older people with frailty are susceptible to sudden and rapid deterioration, so discussing their wishes and preferences for care at the end of life should be a priority. However, frailty is often not considered or recognised, which impedes patient-centred decision-making. AIM: To explore the views and perceptions of senior healthcare professionals regarding the usefulness of the Clinical Frailty Scale (CFS) in identifying frailty; whether a CFS score of severe frailty leads senior healthcare professionals to recognise that the person is likely to be approaching the end of life; and whether a CFS score of severe frailty prompts senior healthcare professionals to have conversations about advance care planning and end of life care with patients...
February 21, 2024: Nursing Older People
https://read.qxmd.com/read/38323475/exploring-the-professional-nurse-advocate-role-and-restorative-clinical-supervision
#4
JOURNAL ARTICLE
Elaine Francis
The professional nurse advocate (PNA) role is the key enabler of delivery of the NHS England Advocating and Educating for Quality Improvement (A-EQUIP) model of professional nursing leadership and clinical supervision. The aim of the PNA role is to provide clinical, educational and well-being support to nurses through restorative clinical supervision. This article describes the PNA role and the A-EQUIP model and discusses some of the challenges experienced by nurses in relation to delivering care to older people and current workforce pressures...
February 7, 2024: Nursing Older People
https://read.qxmd.com/read/38263893/supporting-shared-decision-making-in-medicines-use-with-people-living-with-dementia-and-their-carers
#5
JOURNAL ARTICLE
Lynn Chenoweth
Polypharmacy and inappropriate prescribing of psychotropic medicines are common among people living with dementia and pose considerable health risks. One way of addressing these issues is by involving the person and their carer in shared decision-making. This article discusses some of the issues related to polypharmacy and inappropriate prescribing in people living with dementia and examines the concept of shared decision-making in this context. The author details some practical aids that nurses and other healthcare professionals can use to engage people living with dementia and their carers in shared decision-making about medicines use...
January 24, 2024: Nursing Older People
https://read.qxmd.com/read/38197242/exercise-as-a-falls-prevention-strategy-in-the-care-of-older-people
#6
JOURNAL ARTICLE
Vivian Zinyemba
Older people who sustain a fall may experience a range of adverse outcomes, such as distress, injury and loss of independence. Falls increase the risk of frailty and frailty increases the risk of falls. Regular exercise is a pillar of falls prevention and can have extensive benefits for older people's health, well-being and ability to undertake activities they enjoy. As part of the multidisciplinary team, nurses have a pivotal role in implementing exercise-based falls prevention strategies for older people and in encouraging their patients to exercise...
January 10, 2024: Nursing Older People
https://read.qxmd.com/read/38087856/equipping-the-healthcare-workforce-to-meet-the-complex-health-needs-of-older-people-in-the-community-a-skills-led-approach
#7
JOURNAL ARTICLE
Marie Prior, Susan Blake, Helen Lyndon
The shift towards delivering more clinical care in the community not only supports the healthcare system by avoiding unnecessary hospital admissions, but can also improve outcomes, particularly for older people with complex healthcare needs. Therefore, healthcare organisations need to consider how to ensure their workforce has the capabilities required to provide care in accordance with this new model. This article details a project that involved the design and development of a replicable Ageing Well programme of learning to increase knowledge, skills and confidence among registered and unregistered practitioners, underpinned by a 'skills not roles' strategy...
December 13, 2023: Nursing Older People
https://read.qxmd.com/read/37990584/identifying-incontinence-and-promoting-continence-in-people-living-with-dementia
#8
JOURNAL ARTICLE
Zena Aldridge, Laura Elsegood, Sarah Murray, Alison Wileman
Urinary and faecal incontinence are more prevalent among older people but, like dementia, incontinence is not a normal or inevitable part of ageing. The number of people living with dementia who experience continence issues is likely to be underestimated because many people avoid reporting them as a result of embarrassment and stigma, or because they think incontinence is an inevitable symptom of dementia and that nothing can be done about it. Increased awareness and understanding of the relationship between dementia and incontinence is needed so that nurses can persuade people living with dementia and their family carers to discuss continence issues, assess their needs and provide support...
November 22, 2023: Nursing Older People
https://read.qxmd.com/read/37909070/aesthetic-ways-of-knowing-exploring-mental-health-nurses-experiences-of-delirium-superimposed-on-dementia
#9
JOURNAL ARTICLE
Claire Anne Pryor
BACKGROUND: In the UK, people with delirium superimposed on dementia may be cared for by mental health nurses, however there is little in the literature about the experience of caring for people with the condition from the perspective of mental health nurses. AIM: To illuminate the experiences of mental health nurses caring for people with delirium superimposed on dementia and to explore how mental health nurses 'know' the people they care for using 'aesthetic ways of knowing'...
November 1, 2023: Nursing Older People
https://read.qxmd.com/read/37850272/setting-up-a-journal-club-for-healthcare-professionals-in-an-older-people-s-residential-care-setting
#10
JOURNAL ARTICLE
Anita Duffy, Fiona Lawler, Christine Dalton, Michael Connolly
With the rise in the number of older people in the population and new developments in older people's services such as integrated care hubs, there is a need for healthcare professionals working with older people to keep up to date with the latest research. This article describes the process of establishing a multidisciplinary journal club in a residential care setting and recognising the potential of such clubs to develop staff members' critical thinking, presentation and communication skills. The authors emphasise the importance of fostering a culture of learning in older people's services and describe how a journal club can support healthcare professionals to maintain their knowledge and improve care...
October 18, 2023: Nursing Older People
https://read.qxmd.com/read/37789757/implementing-music-therapy-interventions-in-a-dementia-inpatient-unit-reflections-and-practicalities
#11
JOURNAL ARTICLE
Chris Atkinson, Kate Martin
There is a growing evidence base to suggest that music therapy is an effective clinical intervention for people with dementia, having positive effects on mood, emotion, communication and memory, and reducing agitation, anxiety and apathy. However, the evidence to support this is predominantly from community settings such as residential care homes or people's own homes. This article captures the authors' experiences and reflections regarding their implementation of a music therapy intervention in a dementia inpatient unit...
October 4, 2023: Nursing Older People
https://read.qxmd.com/read/37726987/benefits-of-deprescribing-for-older-people-with-frailty-and-polypharmacy-part-two
#12
JOURNAL ARTICLE
Sue Lyne
Polypharmacy is a significant issue for many older people, including those with frailty, and it is associated with a range of adverse effects. Therefore, it is important to address polypharmacy by optimising patients' medicines use. Medication reviews are one of the main approaches to medicines optimisation, and various tools are available to support healthcare professionals with conducting these. Another approach is deprescribing, which can improve health outcomes for patients and may have financial benefits for healthcare organisations, but can also present various challenges...
September 20, 2023: Nursing Older People
https://read.qxmd.com/read/37670533/benefits-of-deprescribing-for-older-people-with-frailty-and-polypharmacy-part-one
#13
JOURNAL ARTICLE
Sue Lyne
The UK population is ageing rapidly, a trend that is likely to continue due to improvements in chronic disease management and increased life expectancy. Comorbidities, including frailty, become increasingly common with age and as a result it is likely that multiple medicines will be prescribed for older people, leading to polypharmacy. This is a concern because polypharmacy is associated with various adverse effects and an increased medicine burden in this population, as well as a financial burden for the healthcare system...
September 6, 2023: Nursing Older People
https://read.qxmd.com/read/37609709/foot-ulcers-in-older-people-with-diabetes-mellitus-prevention-and-management
#14
JOURNAL ARTICLE
Jayne Robbie
Foot ulcers in a person with diabetes mellitus can be life-changing and threaten the viability of their lower limb. As many as one in three people with diabetes develops a foot ulcer in their lifetime. These foot ulcers are prone to fast-spreading infection and often precede lower-limb amputation. In older people with diabetes, foot ulcers can have significant negative long-term effects in terms of quality of life, morbidity and mortality. Appropriate care is crucial to prevent the development of foot ulcers and to manage them if they develop despite adequate preventive measures...
August 23, 2023: Nursing Older People
https://read.qxmd.com/read/37464806/who-am-i-identity-person-centred-care-and-dementia
#15
JOURNAL ARTICLE
Tom Rose, Karen Harrison Dening
Identity is a central aspect of our lives. Who we believe ourselves to be has profound implications on how we interact with and interpret the world around us. People with dementia often experience stigma and suboptimal care because of a perception that they have 'lost their identity' as the cognitive symptoms associated with the condition progress. This notion is challenged by proponents of person-centred care who argue that a person's identity and worth are based on more than cognitive abilities. Person-centred care is a holistic approach that takes account of the entirety of a person's life and provides support that respects the individual and their self-identity...
July 19, 2023: Nursing Older People
https://read.qxmd.com/read/37403441/introducing-a-group-based-psychoeducation-intervention-for-older-people-in-an-inpatient-mental-healthcare-setting
#16
JOURNAL ARTICLE
Hannah Harrison, Talha Alarakhia, Philip John Archard
This article reports on a service evaluation of a group-based psychoeducation programme for older people in an inpatient mental healthcare setting. It sought to explore how the programme was experienced by patients and staff, as well as its acceptability and the feasibility for implementation in the longer term. Via questionnaires, views were gathered from patients and staff. A focus group interview with staff facilitating the group sessions was also undertaken, and patient attendance records for sessions were collected and compared with demographic data relating to the two wards housed in the unit where the programme took place...
July 5, 2023: Nursing Older People
https://read.qxmd.com/read/37282748/exploring-staff-s-views-on-the-implementation-of-intergenerational-playgroups-in-care-homes
#17
JOURNAL ARTICLE
Kathy Reynolds, Anna Cox
BACKGROUND: Intergenerational playgroups are a formalised way of bringing together older people and young children to 'play and interact'. They can facilitate social interaction and reduce loneliness for older people living in care homes. Although interest in intergenerational playgroups is increasing, there is a lack of research into their implementation. AIM: To explore staff's views on the implementation of intergenerational playgroups in care homes for older people...
June 7, 2023: Nursing Older People
https://read.qxmd.com/read/37221893/dementia-in-care-homes-increasing-the-diagnosis-rate-among-undiagnosed-residents
#18
JOURNAL ARTICLE
Zena Aldridge, Kumar Ponnusamy, Amy Noble, Paul Collier, Diane Smith
It has been estimated that 70% of care home residents have dementia on admission or develop it after admission, but that many do not have or receive a formal diagnosis of dementia. People with dementia often have significant care needs and it is important that the condition is diagnosed even at an advanced stage. This will enable nurses to predict the person's care needs, develop appropriate care plans and arrange pre-emptive decisions. In 2021-22, a quality improvement project took place in care homes in West Norfolk...
May 24, 2023: Nursing Older People
https://read.qxmd.com/read/37161545/ethical-decision-making-in-the-administration-of-as-required-antipsychotics-to-people-with-dementia-in-care-homes
#19
JOURNAL ARTICLE
Jessica Vaughan
Antipsychotic medicines are often prescribed 'as required' to manage behavioural and psychological symptoms of dementia, despite evidence that these medicines have little benefit for people with dementia and have numerous adverse side effects, including sedation. It is the nurse's role to decide if and when to administer antipsychotic medicines that have been prescribed on an as required basis. This decision-making is underpinned by complex ethical considerations such as mental capacity, chemical restraint, quality of life and autonomy...
May 10, 2023: Nursing Older People
https://read.qxmd.com/read/37042318/promoting-resilience-among-older-people-in-prisons-a-systematic-literature-review
#20
JOURNAL ARTICLE
Warren Stewart, Chanel Coppard, Annette Thompson
The number of older people in UK prisons has increased significantly in recent years and most of them have at least one health condition. Research has shown that the physical and mental health of older people living in the community is positively correlated with resilience, but there is limited research on how to promote resilience in older prisoners. This systematic literature review offers a synthesis of interventions, practices and processes that may improve resilience in older prisoners. The review included eight peer-reviewed studies and identified three elements that support resilience in older prisoners: organised interventions; relational activities; and subjective processes...
April 12, 2023: Nursing Older People
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