When is nighttime? A description of bedtime in persons with dementia in the nursing home.

The purpose of this secondary data analysis was to describe the bedtime patterns of persons with dementia in the nursing home and make recommendations for nursing practice. Nursing staff observed, researcher observed, and actigraph data on bedtimes were compared with nighttime facility routines. Seventy per cent (n = 14) of all participants (n = 20) were in bed before 8:30 pm and 30% (n = 6) of the participants went to bed after 8:30 pm.

Factors associated with sleep disturbance among older adults in inpatient rehabilitation facilities.

Purpose: The purpose of this article is to provide an overview of changing sleep patterns and common sleep disorders in older adults and to discuss treatment options of sleep disturbances within inpatient rehabilitation facilities (IRFs).

Methods: Through extensive review of the existing literature, common sleep disorders among older adults and several key factors that may impact sleep in older adults in inpatient rehabilitation facilities, such as behavioral and environmental factors, psychosocial and emotional factors, medical conditions, and medications were identified.

Findings: Current literature on the factors associated with sleep disturbance in older adults in IRFs is based on work with community-dwelling older adults and those in long-term care facilities.

The effects of slow-stroke back massage on minutes of nighttime sleep in persons with dementia and sleep disturbances in the nursing home: a pilot study.

Purpose: This pilot study tested the effects of a 3-minute slow-stroke back massage (SSBM) on total minutes of nighttime sleep on persons with dementia with sleep disturbances aged 65 years or older in the nursing home.

Design: Pilot randomized controlled trial.

Methods: Participants were randomized to an intervention group (n = 20) who received the 3-minute SSBM or a usual care control condition group (n = 20) who received usual bedtime care.

A trial of a comprehensive nursing rehabilitation program for nursing home residents post-hospitalization.

This pilot study examined the feasibility of implementing a comprehensive nursing rehabilitation program (CNRP) designed to promote the physical functioning of moderately frail nursing home residents post-hospitalization. The 4-week to 8-week CNRP incorporated three interventions: the Capacity Intervention (improving strength and balance), Performance Intervention (fostering daily mobility and activity), and Facilitating Intervention (providing education, support, and stress management). A longitudinal design was used with a convenience sample of 24 moderately frail residents.

Challenges in conducting qualitative research with individuals with dementia.

Qualitative research can capture the meaningful experiences and life values of individuals with dementia not reported in quantitative studies. This article shares a personal experience of the challenges faced and the lessons learned while conducting a qualitative study of 15 people with early-stage Alzheimer's disease. The purpose of this article is to discuss the issues concerning determination of capacity to consent to research, consent/assent, communication challenges, and trustworthiness of data when conducting a qualitative study of people with dementia.

Using spirituality to cope with early-stage Alzheimer's disease.

Alzheimer's disease (AD) robs persons living with the disease of their independence and self-esteem, which can lead to depression, anxiety, and loneliness. Understanding how people with early-stage AD cope is a critical step in enhancing their adaptive abilities and ultimately improving their quality of life. This qualitative study describes how individuals with early-stage AD use spirituality to cope with the losses of self-esteem, independence, and social interaction that they face.

Nursing student descriptions that suggest changes for the classroom and reveal improvements needed in study skills and self-care.

This article describes a longitudinal study that took place in a college of nursing with baccalaureate students between 2002 and 2004 at a university medical center. Its purpose was to provide a climate of success for the students yet challenge them to make additional efforts to complete the program. The qualitative section of the study consisted of students answering the following open-ended questions: (1) Describe ways that faculty can help you be successful in the future and (2) What can you do for yourself to achieve the goal of finishing the program? Students identified what change could be made in the classroom, how increased study time and skills might help, and how self-care would facilitate success.

Nursing home staff's views on quality improvement interventions: a follow-up study.

Ongoing problems with nursing home care mandates understanding nursing home staff's perspectives on innovative quality improvement programs. This follow-up study used focus groups to examine the experiences of staff who participated in a clinical trial that involved Quality Indicator (QI) feedback reports, quality improvement training, and APN consultation. The authors found that QI reports provided staff with a benchmark to judge their care and a means to track problems; APN consultation was essential for staff to learn best practices; and staff questioned the validity of the QI reports, which hindered them from seeking new solutions to problems identified in the QI reports.

Prevalence and characteristics of nursing homes residents requiring light-care.

Rising nursing home (NH) costs and the poor quality of NH care make it important to recognize elders for whom NH care may be inappropriate. As a first step in developing a method to identify these elders, we examined the characteristics of NH residents requiring light-care and changes in their care level from NH admission to 12-months. Using data from the Missouri Minimal Data Set electronic database, we developed three care-level categories based on Resource Use Groups, Version III (RUG-III) and defined light-care NH residents as those requiring minimal assistance with late-loss ADLs (bed mobility, transfer, toilet use, or eating) and having no complex clinical problems.

Nursing home quality, cost, staffing, and staff mix.

Purpose: The purpose of this study was to describe the processes of care, organizational attributes, cost of care, staffing level, and staff mix in a sample of Missouri homes with good, average, and poor resident outcomes.

Design And Methods: A three-group exploratory study design was used, with 92 nursing homes randomly selected from all nursing homes in Missouri and classified into resident outcome groups. Resident outcomes were measured by use of quality indicators derived from nursing home Minimum Data Set resident assessment data.

Getting the basics right. Care delivery in nursing homes.

In this study, the key exemplar processes of care in facilities with good resident outcomes were described. It follows that with description of these processes, it is feasible to teach facilities about the basics of care and the ways to systematically approach care so they can adopt these care processes and improve resident outcomes. However, for this to happen key organizational commitments must be in place for staff to consistently provide the basics of care.

Health belief model and reversal theory: a comparative analysis.

Background: In recent years, an increasing number of nurses have demonstrated interest in health behaviour change interventions and research. Despite this heightened enthusiasm, there appears to have been less interest in exploring new and emerging health behaviour change theories.

Aim: The goal of this work is to assist clinicians and researchers to make more informed choices about the use of the Health Belief Model and Reversal Theory in their practice settings and research projects.

Why older adults with light care needs enter and remain in nursing homes.

Many patients in nursing homes receive limited services. In 1996, approximately 17% of the 1.6 million nursing home residents received assistance with two or less activities of daily living (ADL).