J Gerontol Nurs
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Nurses provide health services to an increasing number of older adults in acute care settings. Acute care nurses are committed to giving patients the highest quality care while recognizing the importance of delivering care in a cost-effective manner. In this study, a unit-based, nurse-centered geriatric program is evaluated. ⋯ These include assistance with bathing, eating, sleeping, mobility, and elimination. Fewer participants on the intervention unit reported decline in activities of daily living (ADL) function during hospitalization than did control participants. Participants in both groups stressed the importance of nurses' demonstrating understanding and caring when working with older individuals.
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Physical pain is a significant problem for many older adults, and as many as 83% of nursing home residents reportedly have pain. Unrelieved pain has consequences for elderly individuals' physical and mental health, rehabilitation, and quality of life. Evidence suggests, however, that pain is underdetected and poorly managed among older adults. ⋯ Depression was highest in those for whom pain was not perceived by the NAs and well-being was highest in those residents who denied pain but for whom NAs reported pain. Caregiver characteristics (e.g., age, education, work experience) were not significantly associated with pain congruence outcomes. These findings illustrate the complexities of assessing pain in older adults, and the need to include nursing assistants (NAs) in educational programs focusing on managing pain in elderly nursing home residents.
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Since the 1990 Patient Self-Determination Act, increasing numbers of adults are completing advance directives (ADs), but unfortunately many adults seen in a dementia evaluation program have not completed an AD. This article discusses the issue of individuals with dementia completing ADs. ⋯ A nurse's knowledge about the stages of dementia is essential to helping an individual through the AD decision-making process. Nurses caring for individuals with dementia should assess decision-making context; recognize the emotions of family, friends, and staff; understand the substance and logic of AD requests; and support individuals and their decisions.