Geriatric Nursing - Articles in Press

Associations Between Chewing and Swallowing Problems and Physical and Psychosocial Health Status of Long-Term Care Residents in Taiwan: A Pilot Study - Corrected Proof

Tze-Fang Wang, I-Ju Chen, I-Chuan Li — 2012-01-19

Oral health is often overlooked in institutional elder care but may have an impact on general health and ability to communicate. We aimed to determine the factor associated with chewing and swallowing problems among long-term care residents in Taiwan. Staff nurses trained to evaluate oral health assessed 781 residents using relevant sections of the Minimum Data Set 2.1 for nursing homes (Chinese version), including the Cognitive Performance Scale, Index of Social Engagement, and Activities of Daily Living Scale. Individuals with chewing and swallowing problems (n = 345) tended to be women (odds ratio [OR] = 1.51, P = .019) in smaller facilities (OR = 4.18, P < .001) with fewer natural teeth (OR = 0.54, P = .011); more broken, loose, or carious teeth (OR = 1.74, P = .042); and with more frequently inflamed gums (OR = 2.72, P = .025) than residents without chewing and swallowing problems (n = 436). Residents' chewing and swallowing problems were significantly associated with parenteral/enteral intake, oral health status, nutritional status, concomitant disease and infection, cognitive function, and social engagement.

Raising the Index of Suspicion for Elder Abuse: Cognitive Impairment, Falls, and Injury Patterns in the Emergency Department - Corrected Proof

Carolyn E. Ziminski, Linda R. Phillips, Diana Lynn Woods — 2012-01-19

Cognitive impairment limits older adults' abilities to advocate for themselves, thus heightening their risk for abuse. Some older adults with cognitive impairments who seek emergency department (ED) services may present with injuries suspicious of abuse. A portion of these injuries may be erroneously attributed to accidents such as falls. A retrospective analysis of 2 years of ED data using International Classification of Diseases, Ninth Revision (ICD-9) codes was conducted focusing on characteristics of injuries sustained by persons with co-occurring cognitive impairment and fall status. Cognitive impairment was not significantly related to falls (P = .533). Findings suggest that persons with cognitive impairment have unique injury patterns based on fall status, which has implications for elder abuse screening. Injuries for persons with no fall history included injury to the upper limb (P = .004), contusions (P = .012), and open wounds (P = .000). An increased recognition of common injuries in older adults can aid in elder abuse assessment by providing a reference point for uncommon injuries.

Inner Strength in Relation to Functional Status, Disease, Living Arrangements, and Social Relationships Among People Aged 85 Years and Older - Corrected Proof

2012-01-03

Inner strength is described as an important resource that promotes well-being. We used data from a sample of 185 people in the Umeå 85+ cohort study to relate inner strength and its attributes to objective health variables. The Resilience, Sense of Coherence, Purpose in Life, and Self-Transcendence scales were used to assess aspects of inner strength, and strong correlations between the scales were found. Prevalence of heart failure, chronic obstructive pulmonary disorder, osteoporosis, or diagnosed depression was associated with low inner strength. Significant relationships were also found between high inner strength and various measures of social relationships. Participants with a higher degree of inner strength had better physical health and more satisfying social relationships. The promotion of inner strength should be a major aim of geriatric nursing.

Clinical Feasibility Trial of a Motion Detection System for Fall Prevention in Hospitalized Older Adult Patients - Corrected Proof

2012-01-03

The purpose of this pilot study was to test the feasibility of a wireless 5-sensor, motion detection system (5S-MDS) with hospitalized older adults. Interventions to prevent hospital-based falls in older adults are important to reduce morbidity, mortality, and health care costs. Wearable motion sensors, which track and wirelessly transmit body movements, may identify human movement patterns that immediately precede falls, thus allowing early prevention. Descriptive feasibility study in which 5 hospitalized older adults were recruited to wear the 5S-MDS for 4 hours. Measurement included assessment of participant acceptance, skin integrity, and sensor accuracy. All 5 participants (mean age, 90.2 years) agreed that sensors were acceptable and skin integrity was maintained. The sensor data accurately reflected the patient movements. The 5S-MDS was feasible for 4 hours’ use with hospitalized older adults. It has potential as an early warning system for falls.