Pain and hospice care in nursing home residents with dementia and terminal cancer.

Aim: One condition associated with severe end-of-life pain that can lead to a poor quality of death is cancer. Cancer pain in people with dementia is of particular concern because of communication problems that occur with worsening disease. The aim of the current pilot study was to examine the association between hospice enrolment, dementia severity and pain among nursing home residents who died from advanced cancer.

Characteristics and underlying meaning of hoarding behavior in elders with Alzheimer's dementia: caregivers' perspective.

Background: Dementia and its associated problem behaviors remain bothersome to family and professional caregivers. Exploring characteristics and the underlying meaning of disruptive behaviors in elders with Alzheimer's dementia can be a first step to pursuing patient-centered care. Although hoarding is relatively harmless, unattended excessive hoarding can create health and safety issues for both patients and caregivers.

Assessing advanced cancer pain in older adults with dementia at the end-of-life.

Aim: To assess advanced cancer pain in older adults with dementia at the end-of-life.

Background: Self-report is the gold standard for pain assessment; however, people with Alzheimer's disease may lose the ability to report pain. Biochemical and neuropathological changes occur in Alzheimer's disease that impairs the affective, sensory, and motor pain processing regions of the brain.

Washington State Death with Dignity Act: implications for long-term care.

The Washington Death with Dignity Act (DWDA) allows competent, terminally ill adults to request a lethal dose of medication from a physician. The purpose of this study was to explore knowledge of Directors of Nursing (DONs) in long-term care (LTC) and assisted living facilities regarding the DWDA. Findings of the survey provide insight into DONs' understanding of the law and whether they have provided staff education regarding how to respond to resident requests.

The effects of a web-based intervention on psychosocial well-being among adults aged 60 and older with diabetes: a randomized trial.

Purpose: The purpose of this study is to investigate the impact of a 6-month Web-based intervention on the psychosocial well-being of older adults with diabetes.

Methods: This study was a randomized controlled trial (N - 62) comparing the effects of a 6-month Web-based intervention plus usual care with usual care alone among adults aged 60 years or older with diabetes. The outcomes included quality of life, depression, social support, and self-efficacy.

The application of facial expressions to the assessment of orofacial pain in cognitively impaired older adults.

Background: The anticipated rapid growth in the number of cognitively impaired older adults, declining edentulism and increasing oral health expectations suggest a greater need for comprehensive dental care and effective ways to evaluate orofacial pain in people with compromised mental function and impaired communication skills. The authors conducted a study to evaluate facial expressions as a means of identifying orofacial pain in cognitively impaired and cognitively intact older adults, compared with other available pain assessment tools.

Methods: The authors conducted a prospective comparative study using three alternative pain measurement tools in a sample of 22 older adults.

The Densford Clinical Scholars Program: improving patient care through research partnerships.

The Densford Clinical Scholars Program at the University of Minnesota School of Nursing partners advanced practice nurses and faculty members to design and conduct clinical studies for improving patient care. Benefits have included changes in nursing practice and, on occasion, the practice of other members of the healthcare team; enhanced research skills for clinicians; an enriched professional practice environment; access to clinical facilities for faculty; funding for research; and an expanded network for professional development. The authors describe this innovative partnership.

Frail older patient care by interdisciplinary teams: a primer for generalists.

Frail older patients-unlike younger persons in the health care system or even well elders-require complex care. Most frail older patients have multiple chronic illnesses. Optimum care cannot be achieved by following the paradigm of ongoing traditional health care, which emphasizes disease and cure.

Pain assessment in patients with possible vascular dementia.

PREVIOUS studies comparing Alzheimer's disease (AD) patients with the normal elderly suggest that AD patients experience less pain. In the present study, pain reporting in 20 patients with possible vascular dementia (VaD) was compared to 20 nondemented elderly who had comparable pain conditions. It was hypothesized that, due to de-afferentiation, the possible VaD patients would experience more pain than the cognitively intact elderly.

Treatment of pain for older hip fracture patients across settings.

Purpose: To examine the treatment of pain following hip fracture across settings (hospital to nursing home or rehabilitation facility).

Design: This was a secondary data analysis of two survey design studies that collected data on hip fracture patients in the hospital and for posthospital days at an institutional setting.

Sample: 115 subjects, 65 years or older, who had undergone surgical treatment of a hip fracture.

Older adults with hip fractures. Treatment of pain following hospitalization.

This study examined pain experiences and treatment for older adults in long-term care or rehabilitation settings 3 week after surgical repair of a hip fracture. Pain report and pain treatment for cognitively intact residents were compared with cognitively impaired residents. Two thirds of all participants reported pain.

Gerontologic nurse practitioner preceptor guide.

Geriatric nurse practitioners (GNPs) often serve as clinical preceptors for nurse practitioner students. The Nursing Interest Group of the John A. Hartford Foundation's Geriatric Interdisciplinary Team Training Program recognized a need for a condensed guide that clarifies the role of a GNP preceptor.