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Biomedical subjects

C Dellasega

Publications and source records attributed to C Dellasega.

At least 19 recordsLinked to original sources
PubMed1997

Pharmacologic approaches to chronic pain in the older adult.

A key aspect of chronic pain management in the older adult is pharmacologic. Although not every elderly person has a chronic condition that leads to pain, these illnesses are more frequent in the later years as a consequence of the aging process. An understanding of physiologic changes and suggested pharmacologic interventions for dealing with issues related to chronic pain is essential. The psychosocial, cultural, and cost variables surrounding pain management of the older adult are also important to consider. A brief review of pain types and terminology precedes discussion of the key principles of pain management for the older adult. These principles are based on the guidelines published and distributed by the Agency for Health Care Policy and Research and the American Pain Society and are presented with a clinical focus aimed at improving clinician practice patterns related to pain management in the older adult. Concise, user-friendly medication information is presented to supplement the current knowledge base of practicing clinicians who prescribe analgesics and adjuvant medications for their patients with pain.

Aged↗
PubMed1996

Use of central nervous system medications among elderly home health clients.

Older persons consume a disproportionate share of all medications dispensed in the United States. In particular, medications acting upon the central nervous system (CNS) have been overprescribed for elderly persons, both in and out of the institutional setting. Although researchers have studied drug use by elders who live in the community, little is known about the use of CNS medications by ill older persons who live at home. This descriptive study examined the use of CNS medications in a group of elderly persons (N = 141) admitted to a visiting nurse association for skilled care. Subjects resided in the community of a large midwestern city. Approximately half of the subjects used some type of CNS drug. Sedative/hypnotic and narcotic and opioid analgesics, two categories of medications with the potential for serious side effects, were most frequently prescribed. Nurses in community and institutional settings are in an ideal position to screen and monitor the use of CNS medications by homebound ill elders.

Aged↗
PubMed1996

The psychogeriatric nurse in home health care: use of research to develop the role.

IN THIS ARTICLE, how one home health agency developed services for a high-risk group of clients based on a research study conducted on-site is described. Part of that study compared the cost of home care for cognitively impaired and cognitively intact persons over the age of 65. Although care for older adults with cognitive impairment was less expensive in terms of actual dollars, hospital and agency readmissions were significantly greater for those who were cognitively impaired, which led to greater total costs. Study results document that cognitively impaired older adults have special home care needs. Results were used to develop a special psychogeriatric program within the home health agency where data were collected. A CNS is now the key feature of this program; the CNS role in addressing the special needs of cognitively impaired home health clients is outlined.

Aged↗
PubMed1996

After hospitalization: home health care for elderly persons.

The immediate post-hospitalization outcomes for elderly individuals who received home health services after discharge were compared with those who did not receive home health services. The needs of individuals with cognitive impairment and the "old-old" were major foci of interest. Assessment instruments included the Mini-Mental State Exam, the Delirium Symptom Interview, and the Everyday Problem Solving Test. Data on the use of health services after hospital discharge were collected. Results showed that patients age 80 and older, who received skilled nursing services, were less likely to report health problems or complications than those who had not received skilled nursing services. Because the old-old elderly are more likely to have problems during the immediate post-hospitalization period, this group of patients should be targeted for needs assessment and discharge planning.

Aged↗
PubMed1995

The process and consequences of institutionalizing an elder.

This qualitative study was conducted to examine the decision-making process and its immediate consequences for family members who placed an elderly loved one in a long-term care facility. To explore issues related to the placement process, in-depth interviews were conducted with 7 individuals who had recently (6 weeks or less) placed an older relative. Content analyses of the interviews were conducted, and several common themes related to the decision-making process and outcomes emerged. Most of the subjects had provided personal care for their elderly relative, so placing their loved one in a nursing home often conflicted with their view of themselves as an ideal caregiver. During the process of making the decision, although family members were given advice and suggestions by health care professionals, this input was viewed as inadequate or even detrimental. Ultimately, subjects described making the decision to place an elderly relative in a long-term care facility as a singular process involving "I" rather than "we." The positive and negative role of friends emerged as an important influence during and after the placement process. The informal validation of the decision to place by peers was the one interaction that family members identified as helpful during this process.

Adult↗
PubMed1995

Cholesterol-related health behaviors in rural elderly persons.

1. Hypercholesterolemia in the elderly is a major risk factor for cardiovascular disease. 2. Elderly subjects were found to be concerned about their cholesterol, but awareness of beneficial cholesterol reduction strategies and desirable cholesterol levels were low. 3. Major concerns for the rural elder are accessibility to cholesterol screening, explanation of the results of screening, and education about dietary interventions. 4. Nurses developing health promotion programs for rural elders need to incorporate methods which promote accessibility to screening and follow-up, understandable written information, and family support.

Aged↗
PubMed1994

Use of home health services by elderly persons with cognitive impairment.

Individuals with cognitive impairment are at high risk for institutionalization; thus, they may benefit from the support provided by home health services. The authors studied a cohort of elderly persons admitted to a home health agency, after first assessing them for cognitive impairment. Comparisons were made between cognitively impaired and cognitively intact individuals. Significant differences in the volume and type of services used were found. Management issues for home health agencies are raised.

Aged↗
PubMed1994

Strategies used by home health nurses to assess the mental status of homebound elders.

Home health nursing practice requires the ability to accurately assess elderly clients and, based on this assessment, arrange for needed home care services. Accurate evaluation of a homebound elder's mental status is particularly important, for it indicates whether the individual will be able to survive in his or her home and thereby avoid institutionalization. However, previous studies suggest that nurses in a variety of settings use assessment criteria that result in inaccurate judgements about their client's cognitive status. This study was undertaken to investigate specific strategies used by home health nurses to determine mental status. A convenience sample of 84 home health nurses was surveyed about the assessment criteria they used in their practice. Findings showed that these nurses, like others, rely primarily on orientation to evaluate cognition.

Adult↗
PubMed1994

Nursing process: teaching elderly clients.

1. Nurses responsible for teaching older persons must adjust traditional approaches to address special age-related physical and psychosocial changes. 2. In order to develop effective teaching strategies, nurses should use the nursing process as a guide for identifying key knowledge deficits, establishing realistic goals, incorporating appropriate content, and evaluating learning. 3. The teaching environment, the actual presentation, and the presenter of information all influence the older adult's ability to learn important health-related information.

Aged↗
PubMed1993

The MMSE to assess the cognitive state of elders. Mini-Mental State Examination.

In both nursing practice and research settings, valid and accurate information on the cognitive function of elderly persons is necessary. However, methods and criteria for evaluating an elder's mental status are inconsistent. A formal screening tool such as the Mini Mental State Examination (MMSE) would enable nurse clinicians and researchers to use a common method for identifying cognitive impairment. In addition, the MMSE score can readily describe levels of impairment across settings. Although certain limitations exist when using this instrument, the MMSE has been successfully employed by some nurses in selected clinical and research settings as a brief but accurate screen of cognition in older persons.

Aged↗
PubMed1992

Home health nurses' assessments of cognition.

Assessments of mental status in elderly persons admitted to home health agencies are the basis for decision-making related to resources provided. A home health nurse's perceptions of an elderly client's capacity for self-care determines whether community services will be prescribed. In institutional settings, evaluation of cognition by professional nurses is often incomplete or inaccurate. It was the purpose of this study to compare the judgements of cognition made by nine home health nurses who were admitting elderly clients to a visiting nurse association with scores from an objective measure of mental status. Findings suggest that these nurses relied primarily on orientation as an indicator of cognitive abilities.

Aged↗
PubMed1991

Caregiving stress among community caregivers for the elderly: does institutionalization make a difference?

Nurses in community settings are frequently exposed to elderly persons who receive a significant amount of physical and/or psychosocial support from one or more informal caregivers. Although numerous investigations exist examining stress and coping in persons who provide such care for elderly persons, little is known about the caregiver's status once full-time caregiving ceases. This study describes emotional and physical components of caregiving stress in a convenience sample of 124 caregivers. Of these, 31 had placed their charge in a nursing home, while 93 had not. A multivariate analysis of variance (MANOVA) between placed-nonplaced groups revealed no significant differences in the total score or Role and Personal Strain subscales of the Burden Interview (J. Zarit & S. Zarit, 1983). Implications for community health nursing practice involve providing ongoing counseling and support of the caregiver and his or her charge, preparing both for the placement experience should it be indicated, and continued follow-up care post-placement. Greater collaboration between community-based and institutionally based nurses can facilitate implementation of these strategies.

Alzheimer Disease↗
PubMed1991

The effects of institutional and community experiences on nursing students' intentions toward work with the elderly.

The intentions of nursing students toward working with older adults are similar to those of nurses in general. Several authors have suggested that educational interventions are the key to reversing the reluctance of nursing students to work with elderly persons. In this longitudinal study, the intentions of 39 junior baccalaureate nursing students were examined at three points: prior to any treatment, after clinical work with aged persons in an institutional setting, and after clinical work with aged persons in a community setting. The analysis of variance model run on this data revealed no significant differences in students' intentions as a consequence of their clinical experiences.

Attitude↗
PubMed1991

Meeting the mental health needs of elderly clients.

1. Older individuals in both community and institutional settings have traditionally underused mental health services. Providers of such care devote a minimum of their professional time to those over 65 years of age. 2. Ageism and difficulty with diagnosis are the most frequent explanations for inadequate mental health care to the elderly. This study found that lack of referrals and failure of the aged to seek services partially accounted for underuse. 3. Legislative changes mandating that aged persons be screened for and receive appropriate mental health services will increase the demand for qualified providers. 4. Nursing's approach to care of the older adult, which focuses on both physiological and psychological needs, can facilitate the delivery of comprehensive effective mental health interventions in and out of the institutional setting.

Aged↗
PubMed1991

Perioperative nursing care for the elderly surgical patient.

1. For the surgical client, a nurse's knowledge of the older adult's specialized needs can reduce operative risk and increase the quality of care provided throughout the operative course. 2. Physical changes resulting from the aging process affect every system in the body. These age-related changes have important implications for the elderly surgical clients and their caregivers. 3. Due to the variety of sensory perceptual changes that occur with aging, such as loss of hearing and vision, preoperative teaching and discharge planning methods may require modification.

Aged↗
PubMed1990

Self-care for the elderly diabetic.

Diabetes is a chronic disease; its successful management is largely dependent on the elderly individual's compliance with the treatment regimen. Teaching efforts for elderly clients with diabetes should be tailored to meet the many age-related conditions that affect learning abilities. These include prior experience with the disease, sensory perceptual changes, short-term memory loss, and lack of formal education. Orem's theory of self-care provides an appropriate framework for nurses who work with elderly diabetic clients. For these clients, nursing goals are geared toward having the older person remain as independent and healthy as possible.

Adaptation, Psychological↗