A procedure for withdrawal of sleep medication in elderly women who have been long-term users.

A program for withdrawal of sedative/hypnotic medication was investigated in elderly women, ages 64 to 91. The sleep cycles of 10 drug withdrawal (DW) and 10 non-drug withdrawal (N-DW) subjects were monitored for a 24-hour period for 5 successive weeks, using a nonintrusive recording procedure. The first 2 baseline weeks were followed by 1 week of half-dose, then 2 weeks of full withdrawal for the DW group. The results indicated no demonstrable effect on sleep, sleep complaints, levels of depression, or daytime sleepiness on the DW group. The conclusion is that the procedure of withdrawal from sleep medication over a 2-week period, combined with the use of a substitute pill to maintain the ritual of nightly pill-taking, is appropriate and effective for long-term elderly users.

The role of gerontological advanced practice nurses in geriatric care.

GAPNs have a significant role to play in the care of older people. They provide focused health screening, counseling, crisis intervention, and comprehensive care to this population. They serve as important advocates in directing appropriate utilization of resources and making referrals that promote continuity of care geared to the needs of older adults. GAPNs provide essential educational services to older clients, their families, and other nursing and health care professionals involved in their care. They are innovators in the field of gerontological nursing and geriatric care and initiate or collaborate in research aimed at improving the health status of older persons. GAPNs are true providers of geriatric care, with great potential for serving an increasingly aging society.

Immune response of elderly adults to pneumococcus: variation by age, sex, and functional impairment.

The immune response of 271 elderly persons to the new 23-valent pneumococcal vaccine was studied prospectively. Sera were obtained prevaccination, at 1 month post- and 12 months postvaccination. They were analyzed by radioimmunoassay for the presence of antibody Types 1, 3, 6A, 7F, 8, and 9N. The results showed differences in antibody levels by sex of the individual (p less than .01 pre and p = .04 at 1 month post), with women having lower antibody levels than men. Women responded better to vaccination than men (p = .05), but they also lost their acquired antibodies faster (p less than .01). No age effect and no effect of level of functioning were observed within this group of elderly individuals. Participants who died had high initial levels and responded well. Major differences between the six types were noticed. Type 6A exhibited the described pattern most clearly, whereas Type 3 often behaved in an opposite pattern from the other five types. We conclude that sex differences persist even among elderly adults, that high levels of antibodies are not necessarily an indicator of good health, and that much unexplained variation between antibody types exist.