J Gerontol Nurs
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Review Comparative Study
Family caregivers making life-sustaining treatment decisions: factors associated with role strain and ease.
Although recent studies have focused on life-sustaining treatment (LST) decision-making by families, research has not examined such decision-making as an aspect of ongoing caregiving by family caregivers. This article focuses on factors associated with family caregiver role strain and ease in LST decision-making. ⋯ Factors affecting the strain and ease felt by family caregivers exist not only during the actual decision-making period, but also arise during the days, months, and years prior to the event and continue on after the LST decisions have been made. Nurses' knowledge of these factors can help nurses decrease family caregiver strain and increase ease during the family caregiver LST decision-making process.
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This article is a review of basic, but important information about disaster planning considerations for older populations. The recent hurricane experiences in the South confirmed how critical this planning is, and the importance of early evacuation in saving lives. This is highlighted when comparing the official responses during Hurricane Katrina and Hurricane Rita. ⋯ This requires having the resources and supplies to support at least minimal safe function. However, facilities in locations that could be isolated for longer periods of time should consider having even more supplies in reserve. Recent events may prompt gerontological nurses to ask themselves, their facilities, and communities--Are we prepared?
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Review
Osteoarthritic knee or hip pain: possible indicators in elderly adults with cognitive impairment.
Many elderly individuals with cognitive impairment (CI) suffer from chronic pain resulting from osteoarthritis (OA). They have diminished ability to communicate their pain to health care providers, and when pain is undetected, it may be untreated. ⋯ The review suggests that patients with severe knee or hip OA pain tend to show specific motor patterns, disturbances of gait patterns, and reduction of activity level. Therefore, these behaviors could serve as alternatives to verbal report of chronic pain in elderly individuals with Cl and knee or hip OA.
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Approximately 80% of Americans who die each year are 65 or older. Increasingly, gerontological nurses are asked to deliver high quality end-of-life care. ⋯ Enhancing nursing education and training in end-of-life care is one strategy proposed as a remedy for inadequate care for nursing home residents who are dying. This article reviews the current status of end-of-life nursing home care, describes the philosophy and components of quality palliative care, and provides information about opportunities and resources for educating gerontological nurses in end-of-life care.
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Comparative Study
Nurse staffing in nursing homes in the United States: Part II.
This study compared state minimum staffing standards with actual nurse staffing levels in nursing homes in each state. The actual nurse staffing levels in nursing homes were compared to the nurse staffing levels recommended by experts in 2000 and 2001. ⋯ When actual nurse staffing levels were compared with the minimum standards recommended in a federal report, 97% of all nursing homes had staffing levels below those considered safe. Considerable new federal and state resources are needed to bring the state staffing standards and the actual nursing home staffing levels up to the levels recommended by experts.