Comparing the Experiences of Participants With Mild Cognitive Impairment and Mild Dementia During an Oral Health Intervention.

Background And Objectives: Cognitive impairment is associated with poor oral health outcomes. Oral hygiene tasks are an essential target of interventions aiming to improve oral health for older adults with cognitive impairment. We aimed to examine whether experiences in an oral health intervention based on the Adaptive Leadership Framework for Chronic Illness differed between individuals with mild cognitive impairment (MCI) or mild dementia (MD) and their respective care partners.

A Cross-Sectional, Correlational Study Comparing Individual Characteristics of Younger and Older Nursing Home Residents using Western Canadian Resident Assessment Instrument-Minimum Data Set (RAI-MDS) 2.0.

Objective: To compare characteristics of nursing home (NH) residents by age categories in Western Canada.

Design: A cross-sectional, correlational analysis of secondary data.

Setting And Participants: 89,231 residents living in Western Canada NHs in the provinces of Alberta, Manitoba, and British Columbia in 2016 and 2017.

Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline.

Purpose: To inform overprescribing and antibiotic stewardship in nursing homes (NHs), we examined the concordance between clinicians' (NH primary care providers and registered nurses) diagnosis of suspected UTI with a clinical guideline treated as the gold standard, and whether clinician characteristics were associated with diagnostic classification.

Methods: We conducted a cross-sectional web-based survey of a U.S.

Feasibility of Routine Quality of Life Measurement for People Living With Dementia in Long-Term Care.

Objectives: Maximizing quality of life (QoL) is the ultimate goal of long-term dementia care. However, routine QoL measurement is rare in nursing home (NH) and assisted living (AL) facilities. Routine QoL measurement might lead to improvements in resident QoL.

Younger Nursing Home Residents: A Scoping Review of Their Lived Experiences, Needs, and Quality of Life.

Objectives: The percentage of younger nursing home (NH) residents (ages 18-64 years) in some countries such as the United States and Canada has been increasing over the years. In fact, it is generally held that younger NH residents are considerably different from the older residents (age ≥65 years). There is a need to understand who they are, why they resided in NHs, and their quality of life (QoL).

Potential Side Effects and Adverse Events of Antipsychotic Use for Residents With Dementia in Assisted Living: Implications for Prescribers, Staff, and Families.

Antipsychotic medications are frequently prescribed to assisted living (AL) residents who have dementia, although there is a lack of information about the potential side effects and adverse events of these medications among this population. Oversight and monitoring by family members is an important component of AL care, and it is important to understand family awareness of antipsychotic use and reports of potential side effects and adverse events. This cross-sectional, descriptive study of family members of 283 residents with dementia receiving antipsychotic medications in 91 AL communities found high rates (93%) of symptoms that could be potential side effects and a 6% rate of potential adverse events.

Staff Reports of Behavioral Expressions of Persons With Dementia in 250 Assisted Living Communities.

Background And Objectives: Assisted living (AL) residents with dementia commonly exhibit behavioral expressions (BEs), yet no study has examined how AL staff perceive and respond to BEs in terms of the "ABC" model of antecedents, behaviors, and consequences, or how perceptions relate to organizational characteristics. Understanding staff perceptions may inform interventions.

Research Design And Methods: A convergent, mixed methods design was used in a study of health care supervisors from 250 AL communities in 7 states who reported 366 cases of resident BEs (one successful and one unsuccessful case).

Evaluation of a Training Toolkit to Improve Clinicians' Skills for Dementia Advance Care Planning.

Primary care clinicians care for most persons with Alzheimer's disease and related dementias (ADRDs), yet lack dementia-specific skills in advance care planning (ACP). To develop and evaluate a training toolkit for primary care clinicians to improve ACP communication for people with ADRD and their families. Clinical practice outcomes assessment and pre-post-training evaluation.

To What Extent Do Local Nursing Home Prescribing Patterns Relate to Psychotropic Prescribing in Assisted Living?

Objective: In nursing homes (NHs), psychoactive medication use has received notable attention, but less is known about prescribing in assisted living (AL). This study examined how antipsychotic and antianxiety medication prescribing in AL compares with NHs.

Design: Observational, cross-sectional AL data linked to publicly reported NH measures.

Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse.

Objectives: To determine what information is most important to registered nurses' (RNs) decisions to call clinicians about suspected urinary tract infections (UTIs) in nursing home residents.

Design: Web-based discrete choice experiment with 19 clinical scenarios.

Setting And Participants: Online survey with a convenience sample of RNs (N = 881) recruited from a health care research panel.

Nursing Home Clinicians' Decision to Prescribe Antibiotics for a Suspected Urinary Tract Infection: Findings From a Discrete Choice Experiment.

Objective: To determine which nursing home (NH) resident characteristics were most important to clinicians' decision to prescribe antibiotics for a suspected urinary tract infection (UTI), including both evidence-based and non-evidence-based characteristics.

Design: Web-based discrete choice experiment with 19 clinical scenarios. For each scenario, clinicians were asked whether they would prescribe an antibiotic for a suspected UTI.

The role of Doctor of Nursing Practice-prepared nurses in practice settings.

Background: The role of the Doctor of Nursing Practice-prepared nurse (DNP) outside of academic settings has not been clearly articulated or widely explored, and therefore the value DNP-prepared nurses bring to their practice settings is largely unknown. This study: (1) surveyed existing DNP programs to identify the nonacademic settings in which their DNP graduates were employed and (2) conducted semistructured interviews with employers to identify the role and value of the DNP-prepared nurse in nonacademic settings.

Method: Data were collected from January 2016 to August 2016 in two parts: (1) an online survey of the DNP programs and (2) qualitative semistructured telephone interviews with employers.

Staffing and Service Availability in Assisted Living: The Importance of Nurse Delegation Policies.

Objectives: To examine the health services provided in residential care and assisted living (RC/AL), the staff providing these services, and the degree to which the services relate to state-level nurse delegation policies and other correlates of service provision.

Design: This cross-sectional study descriptively examined the relationships among RC/AL characteristics, services, staffing, and nurse delegation regulations/policies.

Setting: RC/AL settings (N=245) in 8 U.

An untapped resource in the nursing workforce: Licensed practical nurses who transition to become registered nurses.

Background: A more diverse registered nurse (RN) workforce is needed to provide health care in North Carolina (NC) and nationally. Studies describing licensed practical nurse (LPN) career transitions to RNs are lacking.

Purpose: To characterize the occurrence of LPN-to-RN professional transitions; compare key characteristics of LPNs who do and do not make such a transition; and compare key characteristics of LPNs who do transition in the years prior to and following their transition.

New or Worsening Symptoms and Signs in Community-Dwelling Persons with Dementia: Incidence and Relation to Use of Acute Medical Services.

Objectives: To understand the range of symptoms that present to family caregivers of community-dwelling persons with Alzheimer's disease and related dementias (ADRD).

Design: Six-month longitudinal prospective study to identify the incidence of new or worsening symptoms and their association with acute care medical service use.

Setting: Community-based sample of volunteers from multiple states.

Nurse and Medical Provider Perspectives on Antibiotic Stewardship in Nursing Homes.

Objectives: To examine perspectives on antibiotic use and antibiotic stewardship of nurses and medical providers in nursing homes (NHs).

Design: Cross-sectional survey.

Setting: NHs in North Carolina (N = 31).

Antibiotic prescribing in 4 assisted-living communities: incidence and potential for improvement.

Objective: To describe the prevalence, characteristics, and appropriateness of systemic antibiotic use in assisted living (AL) and to conduct a preliminary quality improvement intervention trial to reduce inappropriate prescribing.

Design: Pre-post study, with a 13-month intervention period.

Setting: Four AL communities.

Role of body temperature in diagnosing bacterial infection in nursing home residents.

Objectives: To provide empirically based recommendations for incorporating body temperature into clinical decision-making regarding diagnosing infection in nursing home (NH) residents.

Design: Retrospective.

Setting: Twelve North Carolina NHs.

Fidelity Decision Making in Social and Behavioral Research: Alternative Measures of Dose and Other Considerations.

This article advances the discussion of treatment fidelity in social and behavioral intervention research by analyzing fidelity in an intervention study conducted within participating long-term care settings of the Collaborative Studies of Long-Term Care. The authors used the Behavior Change Consortium's (BCC) best practices for enhancing treatment fidelity recommendations in the areas of study design, provider training, treatment delivery, treatment receipt, and treatment enactment to evaluate fidelity-related decisions. Modifications to the original fidelity strategies were necessary in all areas.

Licensed nurse staffing and health service availability in residential care and assisted living.

Objectives: To create data-driven typologies of licensed nurse staffing and health services in residential care and assisted living (RC/AL).

Design: Cluster analysis was used to describe the patterns of licensed nurse staffing and 47 services and the extent to which these clusters were related.

Setting: RC/AL communities in the United States.

Dementia in relation to family caregiver involvement and burden in long-term care.

To better understand the process and outcomes of family involvement for long-term care residents with varying stages of dementia, we analyzed family and staff data for 467 residents of 24 residential care/assisted living and nursing-home settings. Adjusted analyses found that although the amount of family visitation did not significantly vary by resident cognitive status (15 versus 20 visits/month to persons with and without dementia, respectively), the nature of the visit did. Families of cognitively intact residents spent more time in activities related to social and community engagement, such as taking residents on trips and calling and writing letters (p<.

Differences in assisted living staff perceptions, experiences, and attitudes.

Research within residential care/assisted living (RC/AL) settings has shown that the attitudes of personal care (PC) staff toward their organization and its residents and families can affect the quality of resident care. This article describes the perceptions, experiences, and attitudes of PC staff and their supervisors, and considers these data in the context of non-hierarchical staffing patterns-a philosophically expected, yet unproven tenet of RC/AL. Using data collected from 18 RC/AL communities, these analyses compared the characteristics, perceptions, experiences, and attitudes of PC staff (N = 250) and supervisors (N = 30).

Systematic review: Effective characteristics of nursing homes and other residential long-term care settings for people with dementia.

Objectives: In response to the need for an evidence-based review of factors within long-term care settings that affect the quality of care, this review compared characteristics of nursing homes and other residential long-term care settings for people with dementia and their informal family caregivers with respect to health and psychosocial outcomes.

Design: Databases were searched for literature published between 1990 and March 2012 that met review criteria, including that at least 80% of the subject population had dementia.

Results: Fourteen articles meeting review criteria that were of at least fair quality were found: four prospective cohort studies, nine randomized controlled trials (RCTs), and one nonrandomized controlled trial.

Comparing families and staff in nursing homes and assisted living: implications for social work practice.

Nursing homes and residential care/assisted living settings provide care to 2.4 million individuals. Few studies compare the experience of, and relationships between, family and staff in these settings, despite ongoing family involvement and evidence that relationships are problematic.