Infusing geropsychiatric nursing content into curricula: challenges and solutions.

Nurses of the 21st century are unprepared to care for the increasing older adult population's mental health care needs. Nursing schools across the country struggle to identify and infuse geropsychiatric nursing content into curricula. In 2008, the John A. Hartford Foundation partnered with the American Academy of Nursing to fund a 4-year project, the Geropsychiatric Nursing Collaborative (GPNC). In 2011, four schools of nursing were selected to participate in the GPNC consultation project. This article describes two major challenges that schools currently face as they work to infuse geropsychiatric nursing content into nursing curricula and the solutions offered. Core geropsychiatric nursing competencies and content were identified to assist curriculum mapping, and examples of faculty resources for teaching about depression, dementia, and delirium were outlined. Incorporation of geropsychiatric nursing content is critical for preparing our future workforce to meet the increasing mental health care needs of older adults.

Challenges in efficacy research: the case of feeding alternatives in patients with dementia.

AIMS: To explore factors at the family caregiver and nursing home administrative levels that may affect participation in a clinical trial to determine the efficacy of hand feeding vs. percutaneous gastrostomy tube feeding in persons with late-stage dementia. BACKGROUND: Decision-making regarding use of tube feeding vs. hand feeding for persons with late-stage dementia is fraught with practical, emotional and ethical issues and is not informed by high levels of evidence. DESIGN: Qualitative case study. METHODS: Transcripts of focus groups with family caregivers were reviewed for themes guided by behavioural theory. Analyses of notes from contacts with nursing home administrators and staff were reviewed for themes guided by an organizational readiness model. Data were collected between the years 2009-2012. RESULTS: Factors related to caregiver willingness to participate included understanding of the prognosis of dementia, perceptions of feeding needs and clarity about research protocols. Nursing home willingness to participate was influenced by corporate approval, concerns about legal and regulatory issues, and prior relationships with investigators. CONCLUSION: Participation in rigorous trials requires lengthy navigation of complex corporate requirements and training competent study staff. Objective deliberation by caregivers will depend on appropriate recruitment timing, design of recruitment materials and understanding of study requirements. The clinical standards and policy environment and the secular trends there-in have relevance to the responses of people at all levels.

Facilitating ADLs by caregivers of persons with dementia: the C3P model.

The purpose of this paper is to explicate a change model for caregivers of persons with dementia to assist them in facilitating meals in the home, at community-based programs and in institutional settings. Building on a Social Ecological Model, the C3P Model-Change the Person, Change the People, Change the Place offers a clear method to adapt care strategies to foster independence while providing appropriate support as the person with dementia cognitively and functionally declines. Meals are highly embedded within a culture and are ritualized events within a family requiring an individualized approach when modifications are needed.