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Biomedical subjects

L A Gerdner

Publications and source records attributed to L A Gerdner.

11 recordsLinked to original sources
PubMed2001

Integration of lucid individuals and agitated individuals with dementia in different care units.

The purpose of this study was to illuminate how the integration of lucid individuals and agitated cognitively impaired individuals affects aspects of perceived quality of care. A questionnaire was mailed to hospital wards, nursing home wards and residential homes in Sweden. Nursing staff replied to the questionnaire on behalf of each care unit. Integration of cognitively impaired and lucid patients/residents was identified as a problem, regardless of whether the care unit was a hospital ward, nursing home or residential home. Agitated behaviours in people who were cognitively impaired could result in lucid residents becoming anxious, afraid and irritated. This in turn could lead to an exacerbation of behaviour in residents who were already agitated. Sometimes a lucid patient/resident was required to share a room with an agitated individual. There is a need for staff training specific to the needs of people with dementia. Findings suggest that there is a shortage of units designed specifically for the care of agitated cognitively impaired patients/residents. The findings of this study support the need for healthcare providers in long-term care settings to maintain the rights and well being of all patients/residents.

Adult↗
PubMed2000

Effects of individualized versus classical "relaxation" music on the frequency of agitation in elderly persons with Alzheimer's disease and related disorders.

Confusion and agitation in elderly patients are crucial problems. This study tested Gerdner's mid-range theory of individualized music intervention for agitation. An experimental repeated measures pretest-posttest crossover design compared the immediate and residual effects of individualized music to classical "relaxation" music relative to baseline on the frequency of agitated behaviors in elderly persons with Alzheimer's disease and related disorders (ADRD). Thirty-nine subjects were recruited from six long-term-care facilities in Iowa. The sample consisted of 30 women and 9 men (mean age 82 years) with severe cognitive impairment. Baseline data were collected for 3 weeks. Findings from the Modified Hartsock Music Preference Questionnaire guided the selection of individualized music. Group A (n = 16) received individualized music for 6 weeks followed by a 2-week "washout" period and 6 weeks of classical "relaxation" music. Group B (n = 23) received the same protocol but in reverse order. Music interventions were presented for 30 minutes, two times per week. The Modified Cohen-Mansfield Agitation Inventory measured the dependent variable. A repeated measures analysis of variance with Bonferroni post hoc test showed a significant reduction in agitation during and following individualized music compared to classical music. This study expands science by testing and supporting a theoretically based intervention for agitation in persons with ADRD.

Aged↗
PubMed1998

Probable reasons for expressed agitation in persons with dementia.

Nursing home patients with dementia were videotaped in three previous studies. Sixty sequences of nine patients exhibiting agitated behaviors were examined to identify the most probable antecedents to agitation. Probable reasons were interpreted and applied to the Progressively Lowered Stress Threshold model, which suggests that agitation is stress related. Analysis suggests that agitation often serves as a form of communication. Two underlying reasons seem to be that the patient had loss of control over the situation and deficient autonomy. The most common causes for expressed agitation were interpreted as discomfort, a wish to be served immediately, conflict between patients or with nursing staff, reactions to environmental noises or sound, and invasion of personal space. It is recommended that nursing staff promote autonomy and independency for this group of patients whenever possible. By evaluating probable reasons for expressed agitation, the nursing staff can take steps to prevent or alleviate agitation.

Aged↗
PubMed1996

Caregiver training for people with Alzheimer's based on a stress threshold model.

A caregiver training protocol for Alzheimer's disease and related disorders (ADRD) is presented for dementia management based on the progressively lowered stress threshold model. The training protocol is described using criteria for a nursing intervention including: (a) characteristics of the nursing diagnosis, (b) research base for the intervention, (c) desired patient outcomes, (d) acceptability to the patient, (e) capability of the nurse, and (f) feasibility for doing the intervention. A national study is described which is currently underway to further evaluate the effects of the training protocol.

Alzheimer Disease↗
PubMed1995

Uncovering and managing denial during the research process.

This article describes experiences of geropsychiatric nurses examining the effectiveness of the Progressively Lowered Stress Threshold Model for caregivers of persons with Alzheimer's disease and related disorders, and briefly reviews the literature on coping and denial. This research project, and those of many other psychiatric nurses, is predicated on the expectation that subjects will be able to acknowledge and report to investigators their personal and intimate responses to the challenges and everyday experiences of caregiving. Clearly, the research findings will be most valid if subjects are completely open about all aspects of their experiences, no matter how painful; yet this is often an idealized expectation. Therefore, this article also explores the concerns of geropsychiatric nurse researchers attempting to balance sensitivity to the needs of subjects and the reliability and validity of the data.

Adaptation, Psychological↗
PubMed1995

Standardized care plan. Managing Alzheimer's patients at home.

1. Family-provided care of members with Alzheimer's disease and related disorders (ADRD) is complicated by the presence of secondary behavioral symptoms, such as agitation, that lead to caregiver depression, burden, and breakdown. 2. Caregiver education to manage secondary symptoms in ADRD can be simplified by using a theoretical framework of person-environment fit, providing a selection of interventions to modify the environment to reduce demand on the dwindling resources of the demented person. 3. The Progressively Lowered Stress Threshold (PLST) model identifies six areas of stress for persons with ADRD fatigue, change of caregiver, environment or routine, demands to achieve beyond capability, multiple and competing stimuli, affective response to perceived losses, and physical stressors.

Aged↗
PubMed1995

Shining through: the humor and individuality of persons with Alzheimer's disease.

1. Elders with diminished levels of cognitive functioning are capable of providing meaningful, consistent responses that illustrate individual expressions of self. 2. The demented elder's history and experiences may provide important clues to understanding his or her current behaviors, verbalizations, and perceptions. 3. Humor may be used as a therapeutic intervention for persons with dementia and as a coping strategy for caregivers.

Aged↗
PubMed1994

A nursing challenge: Assessment and management of agitation in Alzheimer's patients.

1. Agitation in patients with Alzheimer's disease is a pervasive problem. The behaviors associated with agitation may have detrimental effects on the patient, health care providers, and other patients. 2. Management of these behaviors is particularly challenging and, at times, frustrating for nursing personnel. 3. Attempts to identify the causative factors are essential to the development of an individualized plan of care.

Aged↗
PubMed1993

Effects of individualized music on confused and agitated elderly patients.

The Progressively Lowered Stress Threshold Model in conjunction with an identified theoretical basis provides a framework for the use of individualized music in individuals with Dementia of the Alzheimer's Type (DAT). The effects of individualized music is explored in five elderly patients who are confused and agitated and residing in a long-term care facility. The Modified Cohen-Mansfield Agitation Inventory is used to measure the outcome. The immediate and 1-hour residual effects suggest the potential of individualized music as an alternative approach to the management of agitation in confused elderly patients.

Aged↗
PubMedDate not supplied

Statewide survey to compare services provided for residents with dementia in special care units and non-special-care units.

To protect the consumer, consistency is needed in what one can expect when a long-term care facility (LTCF) advertises having an Alzheimer's special care unit (SCU). Arkansas recently passed disclosure legislation, which has led to the development of criteria for licensure of SCUs. This study compared the extent to which Arkansas LTCFs, with and without SCUs, met these criteria. We conducted a statewide survey of 238 LTCFs prior to the enforcement of these regulations and will conduct the same survey following their enforcement. Of the 147 (62 percent) facilities responding, 24 (16 percent) had a SCU. None of the LTCFs with SCUs met all the state criteria. The number and quality of services provided in SCUs and non-SCUs were similar.

Alzheimer Disease↗