J Gerontol Nurs
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Randomized Controlled Trial
Exploring aging-related stress among older spousal caregivers.
The goal of this study was to explore aging-related stress among older spousal caregivers providing hospice care for an older adult with cancer. Cases were selected from an ongoing randomized controlled trial that involved audiorecorded visits with caregivers over four different time points. Recordings consisted of caregivers discussing caregiving problems and ways they attempted to cope. ⋯ Caregiving stress primarily involved the patients' cognitive deficits. The caregiving experience also made older caregivers aware of their own aging and physical limitations, heightened self-imposed expectations to fulfill their role as spouse, and led them to consider their own mortality. This study informs development of caregiver interventions aimed at addressing the reciprocal challenge of caregiving and aging.
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This article reviews the literature on advance directives among U. S. older adults published from 2008 through 2013, with a focus on advance directive prevalence, implications of advance directives on patient care, and impact of interventions to increase advance directive completion. ⋯ Advance directive completion increases when health care providers ask culturally sensitive questions and educate patients about advance directives, but better documentation and communication of advance directives are needed to ensure adherence to these measures. Despite increasing advance directive completion as patients move from community to nursing homes to hospice, advance directives are often insufficiently detailed and current for health care professionals to be confident they are acting in accordance with what patients would choose for themselves.
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Unscheduled return visits to the emergency department (ED) represent a considerable segment of older adults' total visits to the ED. This study explores the factors that led to early return visits to the ED by older adults. Using a qualitative descriptive design, semi-structured interviews were conducted in a large teaching hospital with 15 older adults who returned to the ED within 2 weeks after an initial visit. ⋯ These were Managing the Symptoms, Care Curing the Initial ED Visit, and Who I Am. The findings suggest that the main reason for older adults' return to the ED is the severity of the symptoms they experienced. Ensuring the timeliness of follow-up appointments and the provision of resources to support the transition home are identified as interventions that would improve the care provided in EDs.
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Poor sleep in later life is a global issue that reduces many individuals' quality of life (QOL). The purpose of this pilot study was to test the feasibility and effects of a simplified tai chi exercise intervention on sleep quality and QOL among Chinese community-dwelling older adults with poor sleep quality. This single-group, descriptive feasibility study included 34 individuals with poor sleep quality who agreed to participate in a 12-week tai chi intervention. ⋯ Older adults with poor sleep quality who completed the intervention showed significant improvement in the Medical Outcomes Study Short Form-36 mental component and the Pittsburgh Sleep Quality Index global and component scores. The low recruitment and attendance and high dropout rates might be associated with participants' age, gender, and sleep quality. Further long-term studies are required to examine the potential effects of the tai chi intervention. [Journal of Gerontological Nursing, 40(3), 46-52.].