Biomedical subjects

A A Thompson-Heisterman

Publications and source records attributed to A A Thompson-Heisterman.

5 recordsLinked to original sources

PubMed1994

Risk profiles for nursing home placement of rural elderly: a cluster analysis of psychogeriatric indicators.

In an effort to better understand the clinical and functional status of patients served by our Rural Elder Outreach Program, more effectively identify risk groups, and more efficiently target services, we performed a cluster analysis on 92 older adults served by our program. The first cluster included patients with very poor health, mild cognitive impairment, very high care demands, and migrating toward active risk for institutionalization. The second cluster included patients with poor physical but good mental health, intact cognition, high care demands, and at passive risk. The third cluster comprised patients with high functional, physical, and cognitive impairment, intensive care demands, moderate mental health problems, poor insight into their situation, and at active risk for institutionalization.

Activities of Daily Living↗

PubMed1994

Multidisciplinary assessment of patients with Alzheimer's disease.

The complexity of AD necessitates that multiple disciplines interface effectively in the assessment of patient, caregiver, and family. This multidisciplinary effort should not be focused on the mere exchange of data. As this article emphasized, just from the perspective of nursing, it is critical that the various disciplines involved know about the purpose, focus, and process of assessment approaches used by each in the convergent effort to comprehensively evaluate the disease and its possible changes, as well as its impact on function, cognition, behavior, and emotion. From this article, it should be apparent that effective multidisciplinary assessment is not exchange of data but rather purposive interchange of clinical information to achieve the clinical goals of assessment, diagnosis, explanation, intervention, prognosis, and evaluation.

Alzheimer Disease↗

PubMed1993

Psychogeriatric outreach to rural families: the Iowa and Virginia models.

Elderly residents of rural areas are at significant risk for mental health problems, yet have less access to mental health services. Thus, most mental health problems among rural elderly remain either undiagnosed or untreated. We describe two models of mental health outreach programs to rural elderly in Iowa and Virginia, serving demographically, culturally, and epidemiologically different populations in geographically and economically dissimilar regions. Programs are compared on the basis of initiation, community partnerships, target population, target region, clinical disciplines involved, coordinating discipline, referral sources, operational model, initial home assessment, care planning, sustainability, cost, patient demographics, and primary and secondary diagnosed. Outreach programs are argued to be effective models of delivering services to geographically and/or socially isolated elderly populations. The experiences of our programs, though limited to rural populations, may be of relevance to any outreach program attempting to serve elderly presenting with or at risk for mental health problems.

Aged↗

PubMed1992

Assessing geropsychiatric patients.

Although other disciplines involved in the care of geriatric patients with psychiatric or neurobehavioral problems have established assessment procedures, this is not the case for nursing. Some approaches to assessing geropsychiatric patients from a nursing perspective have been proposed (Baldwin, 1987; Burnside, 1981; Ninos, 1985), but they have been limited in scope (Abraham, 1990b). However, with nursing assuming an increasingly central role in the multidisciplinary care of geropsychiatric patients and their families, a comprehensive and accepted method of multidimensional geropsychiatric nursing assessment is necessary. This method enables nurses to provide the best possible nursing care to patients and families while contributing effectively to multidisciplinary assessment and intervention. To this end, Abraham and associates (Abraham, 1990a; Thompson-Heisterman, 1992) developed the Psychogeriatric Nursing Assessment Protocol (PNAP). Previous articles have described the rationale and content of the PNAP (Abraham, 1990a; Thompson-Heisterman, 1992). This article will draw on the authors' clinical experience in using the PNAP and will offer practical clinical strategies for assessment within the PNAP framework. The PNAP is presented in the Figure, and readers are referred to previous articles for detailed descriptions of the various aspects of the PNAP. A rating form has been developed for use with the PNAP that permits quantification of clinical observations and the determination of selected clinical scores.

Caregivers↗

PubMed1991

Outpatient psychogeriatric nursing services: an integrative model.

The complex needs of psychogeriatric patients and their families require specialized outpatient psychogeriatric services. The interaction of physical and mental health and the need for coordinated care places important responsibilities on nursing because it contributes to integrated, multidisciplinary care delivery to these patients and their families. This article presents a model of outpatient psychogeriatric nursing services focused on the community integration of patients and families. Experiences in the development of the Geriatric Neuropsychiatry Clinic at the University of Virginia, Charlottesville, are used as the point of departure from which to describe a model of outpatient psychogeriatric nursing care delivery that is multidisciplinary, clinically innovative, and epidemiologically justified.

Aged↗