Using a healing touch intervention in older adults with persistent pain: a feasibility study.

The purposes of this pilot study were to determine the feasibility of using a Healing Touch (HT) intervention with noncommunity-dwelling older adults experiencing persistent pain and to determine an HT protocol. Data were collected at multiple time points from 20 noncommunity-dwelling older adults experiencing pain. Residents were assigned to the HT group that included techniques specific for pain or a Presence Care group.

Healing touch for older adults with persistent pain.

The purpose of this report was to provide an in-depth review of responses from older adults residing in long-term care facilities receiving Healing Touch (HT) for pain management. Persistent pain is common in this population and, while the mainstay for pain management is analgesics, HT may provide supportive therapy. Twenty older adults from 5 facilities in the southwestern United States participated in the study, with 12 receiving the active intervention of HT and 8 receiving the control of presence care.

Behavioral indicators of postoperative pain in older adults with delirium.

The undertreatment of postoperative pain in older adults with delirium is attributed, in part, to the inability to complete self-report pain assessment instruments. Patients' loss of verbal skills to self-report pain and the lack of reliable and valid postoperative pain assessment instruments for use in older adults with delirium prompted the design of a study to identify common and subtle behavioral indicators of pain. Sixteen experienced registered nurses participating in four focus groups identified behavioral indicators of pain.

Evaluation of musculoskeletal pain management practices in rural nursing homes compared with evidence-based criteria.

Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guideline proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes.

Tools for assessment of pain in nonverbal older adults with dementia: a state-of-the-science review.

To improve assessment and management of pain in nonverbal older adults with dementia, an effective means of recognizing and evaluating pain in this vulnerable population is needed. The purpose of this review is to critically evaluate the existing tools used for pain assessment in this population to provide recommendations to clinicians. Ten pain assessment tools based on observation of behavioral indicators for use with nonverbal older adults with dementia were evaluated according to criteria and indicators in five areas: conceptualization, subjects, administration, reliability, and validity.

Bioelectrical impedance analysis and other hydration parameters as risk factors for delirium in rural nursing home residents.

Background: The study investigators conducted a vigorous screening protocol for delirium in rural long-term care (LTC) facilities for a period of 28 days focusing on Bioelectrical Impedance Analysis (BIA) and other hydration parameters as risk factors.

Methods: A two-stage cluster sampling procedure was used to randomly select participants (n = 313) from 13 LTC facilities located in southeastern Iowa, stratified on facility bed size. BIA was used to estimate intracellular water (ICW), extracellular water (ECW), and total body water (TBW) on four occasions--baseline and follow-up days 7, 14, and 28.

Caring for the incontinent elder: advanced practice nursing concepts.

Urinary incontinence (UI) in the older adult is a multisystem health problem that has an impact on the lives of millions of older adults. Advanced practice nurses (APNs) specializing in gerontology,family, and adult practice are equipped educationally with the expertise to prevent, assess, and manage this health problem. The emerging emphasis on UI prevention will help guide the practice of APNs in the future.

The unequal burden of pain: confronting racial and ethnic disparities in pain.

Context: Pain has significant socioeconomic, health, and quality-of-life implications. Racial- and ethnic-based differences in the pain care experience have been described. Racial and ethnic minorities tend to be undertreated for pain when compared with non-Hispanic Whites.

The development and testing of the PATCOA to assess pain in confused older adults.

The purposes of this study were to develop and evaluate the psychometric properties of an instrument with nonverbal cues to assess pain in confused older adults, and to describe the differences among selected demographic variables and scores on the pain and confusion measures. The Pain Assessment Tool in Confused Older Adults (PATCOA) was evaluated with 116 cognitively intact older adults undergoing orthopedic surgery. The interrater reliability for each nonverbal cue ranged from 56.