Rural residence and prescription medication use by community-dwelling older adults: a review of the literature.

Context: Due to various barriers to health care access in the rural setting, there is concern that rural older adults might have lower access to prescribed medications than their urban counterparts.

Purpose: To review published research reports to determine prevalence and mean medication use in rural, noninstitutionalized older adults and assess whether rural-urban differences exist.

Methods: PubMed, Ageline, Cinahl, PsycInfo, International Pharmaceutical Abstracts, Agricola, and Institute for Scientific Information Web of Science - Social Science Index were searched.

Smoke-free policies in the psychiatric population on the ward and beyond: a discussion paper.

Healthcare facilities from a number of countries have or are in the process of implementing smoke-free policies as part of their public health agenda and tobacco control strategy. Their main intent is to prevent the harmful effects of environmental tobacco smoke on employees and patients. However, these protection policies are often implemented before taking into account the specific needs of patients in psychiatric facilities and are clouded by a lack of knowledge, myths and misconceptions held by a variety of stakeholders.

Giving voice to informal caregivers of older adults.

This study focused on the experiences of informal caregivers of older adults and explored whether employment, use of home-care services, or other factors influence the health of caregivers and their ability to manage their caregiving and other responsibilities. Focus groups conducted with 26 caregivers and personal interviews with 4 caregivers identified 12 themes under 5 conceptual areas: caregiver health, relationships, independence, employment, and use of home-care services. The findings reveal that caregiving coupled with other responsibilities can have serious health effects.

Palliative sedation: nurses' perceptions.

Patients with advanced illnesses suffer from a myriad of distressing symptoms. Palliative care aims to alleviate the distress caused by such symptoms. In extreme circumstances palliative sedation may be implemented to manage symptom distress that is not responsive to standard treatment modalities.

Cognitively impaired older adults: risk profiles for institutionalization.

Background: This study focused on the identification of risk profiles for institutionalization among older adults diagnosed with cognitive impairment-not dementia or dementia in 1991/92 and subsequent institutionalization in the following 5-year period.

Methods: Data were from a sample of 123 individuals aged 65+ and their unpaid caregivers in Manitoba, Canada. Cluster analysis was conducted using baseline characteristics of age, cognition, disruptive behaviors, ADLs/IADLs, use of formal in-home services, and level of caregiver burden.

Advance directives and community-dwelling older adults.

Advance directives (ADs) are documents that allow competent individuals to set forth their medical treatment wishes and/or to name a proxy in the event that they lose the capacity to communicate these decisions in the future. Despite the benefits of and support for such documents, very few people have completed an AD. This posttest-only experimental study examined whether an individualized intervention given to half of the older adults who attended an educational session increased the discussion and/or completion of ADs.