J Gerontol Nurs
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The emergency department (ED) can pose an increased risk for frail older adults. As the number of older adults in the general population grows, so will the number of older adults who seek care in the ED. This article examines the kinds of problems for which older adults visit the ED and the assessments that can be performed to help reduce risks. Geriatric-friendly waiting areas, comprehensive discharge planning, and alternatives to ED visits are explored.
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Advanced dementia is a terminal condition; however, research has revealed that affected individuals are subjected to multiple intrusive and burdensome interventions. Individuals with advance dementia require palliative care long before their death. This article reviews selected approaches that support personhood, explain behavior management principles, assure meaningful connections for activities of daily living, minimize weight loss, and explain advance directives and medical management best practices in palliative care for advanced dementia.
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This pilot study investigated the effect of individualized music on agitation in individuals with dementia who live at home. Fifteen individuals listened to their preferred music for 30 minutes prior to peak agitation time, two times per week for 2 weeks, followed by no music intervention for 2 weeks. ⋯ The findings showed that mean agitation levels were significantly lower while listening to music than before listening to the music. The findings of this pilot study suggest the importance of music intervention for individuals with dementia who live at home.
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The purpose of this study was to determine the extent to which nursing home staff adhere to current evidence-based guidelines to assess and manage persistent pain experienced by elderly residents. A retrospective audit was conducted of the medical records of 291 residents of 14 long-term care facilities in western Washington State. Data revealed a gap between actual practice and current best practice. ⋯ Nonpharmacological pain management methods were rarely implemented. Nursing home staff and administrators must critically examine both system and individual staff reasons for failure to comply with best pain management practices. Research is needed to determine factors that contribute to less-than-optimal adherence to evidence-based guidelines for pain management, as well as the best methods for implementing practice change.