Aging Couple Across the Curriculum.

Aging Couple Across the Curriculum is a unique program designed around a couple who "age" a decade with each year of medical school. In these half-day sessions, students encounter the aging couple through a standardized patient experience. Interactive breakout sessions conducted by multidisciplinary professionals enhance student learning and appreciation of the contributions of the team of professionals. A panel of elder specialists provides personal insight into how they have overcome and/or adapted to various health-related problems. Evaluation measures have indicated that students are benefiting from the program and that it is affecting their attitudes in a positive way toward caring for older adults.

Infection in the elderly.

Many functional, demographic, and immunologic changes associated with aging are responsible for increasing the incidence and severity of infectious diseases in the elderly. Management is complicated by age-related organ system changes. Because many of the elderly are on multiple medications for underlying illnesses, antimicrobial therapy needs to be chosen keeping drug interactions and adverse events in mind. Common infections seen in the elderly are infections of skin and soft tissue, urinary tract, respiratory tract, and gastrointestinal tract. Organized and well-funded programs to address infectious disease issues in the elderly are the only way to improve care.

Tangling with the barriers to culture change: creating a resident-centered nursing home environment.

Prior to beginning culture change, nursing homes should analyze potential barriers, such as staff turnover, and develop plans to deal with these barriers. Infusion of culture change is dependent on inversion of the organizational structure, placing decision-making in the hands of the older adults. Although data from this study indicated decreased depression in older adults and increased family satisfaction with culture change, there were many confounding variables. Evaluation of culture change can be enhanced by using repeated measures and qualitative techniques.

A simulated couple aging across the four years of medical school.

BACKGROUND: The medical students of today will deliver health care to an ever-increasing aging population. Regardless of specialties, physicians must view older patients holistically with attention to medical, psychosocial, and family issues and functional status. DESCRIPTION: This program was designed around a couple who ages from 60 to 90 over the 4 years of medical school. The woman represents the healthy aging process, whereas the man represents an elder experiencing multiple health problems. Through standardized patient experiences, small-group encounters, and paper-based learning modules, students address typical age-related issues that provide experiences representative of aging in today's society. EVALUATION: Sessions were rated good to excellent. Comments were positive, especially regarding interactions with the aging couple. CONCLUSIONS: Aging Couple Across the Curriculum allowed the interweaving of multiple issues that are characteristic of many geriatric cases. Students were able to see the complexity of issues and the impact on other family members.

The Sh-h-h-h Project: nonpharmacological interventions.

Promoting rest and sleep is integral to the profession of nursing. The Sh-h-h-h Project, a nonpharmacological program designed to enhance rest and sleep, was implemented on a hospital medical unit. Nursing assistants provided patients with various modalities to improve sleep, including back rubs, warm drinks, blankets warmed in a blanket warmer, aromatherapy, relaxation music, and earplugs. Additional interventions were taken to reduce noise. The outcomes of the Sh-h-h-h Project are reported here, with patients indicating improved sleep quality and quantity.

Helping hands: CNAs in elder care.

One facility's functional model of care for hospitalized elders focuses on improving nutrition, toileting, and promoting mobility.

Satisfaction and retention of CNAs working within a functional model of elder care.

With a functional model of care for hospitalized elders focused on improving nutrition and toileting and promoting mobility, certified nurse assistants' satisfaction was improved and turnover was reduced.

A model of nurse assistant care to promote functional status in hospitalized elders.

After completing 20 hours of classes on promoting the functional status of hospitalized elders, the certified nursing assistants on this medical unit participated in developing a new model of care delivery. Discharge destination (home or nursing home) and length of stay were compared for patients pre- and post-implementation. Length of stay decreased by 2.4 days (p =.0007), and there was a significant increase in the number of elders who were able to return home (p =.024).

From nursing home to hospital and back again: an educational program to improve care for hospitalized nursing home patients.

Hospital nurses have little knowledge of the geriatric syndromes and the processes of caregiving in nursing homes. This lack of knowledge is a barrier to continuity of care for patients admitted to hospitals from nursing homes. An educational program, including both classroom and clinical components, was designed to help bridge this gap. A plan for dissemination to other hospital staff was developed by the 15 nurses who participated.

Can a beverage cart help improve hydration?

The purpose of this study was to determine the effectiveness of a hydration program to improve hydration and prevent conditions associated with dehydration (delirium, urinary tract infections, respiratory infections, falls, skin breakdown, and constipation). Data showed a significant increase in fluid in each body compartment, significant decrease in the number of laxatives, increase in the number of bowel movements, decline in the number of falls, and decrease in cost during the hydration period.