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Biomedical subjects

Terry Fulmer

Publications and source records attributed to Terry Fulmer.

24 records · Page 2Linked to original sources
PubMed2002

Elder mistreatment.

Elder mistreatment (EM) is a serious and prevalent syndrome that is estimated to affect between 500,000 to 1.2 million older adults in the United States annually (Pillemer & Finkelhor, 1988). This chapter reviews both the state of the published science and limitations in the knowledge base on the topic. The literature for this review was obtained through computer-assisted searches of PubMed (878 citations), the Cumulative Index of Nursing Research (CINAHL) (593 citations) and Psych-Info databases (443 citations). The search terms used were elder mistreatment, elder neglect, elder abuse, or domestic abuse of the elderly. No limit was placed on the age of publications because of the relative scarcity of research on the subject. Nonnursing articles were included because there are so few nurse researchers addressing this topic. The age limit for subjects in these studies was 65 years and older. Studies were limited to those conducted in the United States, and descriptive studies were included as they form the majority of the research to date. Findings indicate that frail, very old (over 75 years), older adults who have a diagnosis of depression or dementia are more likely to be mistreated (Dyer, Pavlik, Murphy, & Hyman, 2000; Coyne, Reichman, & Berbig, 1993; Fulmer & Gurland, 1996; Lachs & Pillemer, 1995; Lachs et al., 1997; Lachs, Williams, O'Brien, Pillemer, & Charlson, 1998; Lachs & Fulmer, 1993; Lachs, Berkman, Fulmer, & Horwitz, 1994). Those older adults who required assistance with activities of daily living had poor social networks and were at higher risk for EM (Lachs & Pillemer, 1995; Lachs et al., 1997; Lachs et al., 1998; Lachs & Fulmer, 1993; Lachs et al., 1994). Neglect, as a subcategory of EM, accounts for the majority of cases (Fulmer, Paveza, Abraham, & Fairchild, 2000; Pavlik, Hyman, Festa, & Bitondo Dyer, 2001; Fulmer & Gurland, 1996). There is still debate regarding the role of minority status, abuse in childhood, and the persons most likely to mistreat older adults. There is a critical need for replication studies and new research on this important topic. Problems with measurement, funding challenges, and the paucity of investigators conducting research on EM have left the field with several unanswered questions and some conflicting findings. This chapter summarizes the interdisciplinary literature and makes recommendations for future nursing research programs.

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Gerontological nursing content in baccalaureate nursing programs: comparison of findings from 1997 and 2003.

In 2003, the John A. Hartford Foundation Institute for Geriatric Nursing (Hartford Institute), in collaboration with the American Association of Colleges of Nursing, conducted a survey of baccalaureate schools of nursing in the United States to compare gerontological content to baseline data collected by the Hartford Institute in 1997. Since last surveyed in 1997, baccalaureate nursing programs have been the recipients of substantial new resources and initiatives focused on gerontological curriculum enhancement. While these initiatives are ongoing, and some are in an early stage of development, resurveying baccalaureate programs was seen as a means of taking a midcourse "pulse" as to the effectiveness of these efforts. Data suggest that there has been a fundamental shift in baccalaureate curriculum toward incorporation of a greater amount of gerontological content, integration of gerontological content in a greater number of nursing courses, and more diversity of clinical sites used for gerontological clinical experiences. As baccalaureate programs increasingly address the need to enhance gerontological nursing curricula, there continues to be an obligation to address the growing shortage of faculty with qualifications in gerontological nursing.

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Gerontologic nurse practitioner preceptor guide.

Geriatric nurse practitioners (GNPs) often serve as clinical preceptors for nurse practitioner students. The Nursing Interest Group of the John A. Hartford Foundation's Geriatric Interdisciplinary Team Training Program recognized a need for a condensed guide that clarifies the role of a GNP preceptor. This guide uses information from the literature to clarify the role of the preceptor, offer suggestions for clinical teaching, provide guidance to determine expectations for student performance, and delineate the progression of a nurse practitioner student. This article reviews the contents of the guide and offers suggestions for its use in clinical practice.

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Nurses Improving Care for Healthsystem Elders (NICHE): using outcomes and benchmarks for evidenced-based practice.

This article describes Nurses Improving Care for Healthsystem Elders (NICHE), a project begun in 1992 with four pilot hospitals. These pilot hospitals gathered baseline data using a geriatric institutional assessment profile (GIAP) with a pre- and postdesign to capture changes in staff attitudes, knowledge, and perceptions of the care of older adults. Based on the success of the pilot effort, NICHE, now in its eighth year, has evolved into a program that involves 32 health systems comprising 105 hospitals nationally. To date, more than 10,000 GIAPs have been collected by NICHE hospital staff. All NICHE settings are able to benchmark their GIAP data against comparable institutions (eg, urban, rural, university, community settings) to understand how they compare and then interpret the data at their unique sites. The opportunities for continuous quality improvement through the NICHE program are described.

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Elder mistreatment in women.

Elder mistreatment is a serious syndrome that affects more than 1.5 million older Americans every year. Actions such as abuse, neglect, exploitation, and abandonment by caregivers, relatives, friends, or acquaintances can have devastating sequelae for the elderly. Such actions may be intentional or unintentional, but the detrimental outcomes for older individuals can destroy the elder's quality of life and health. A lack of empirical research addresses gender differences in elder mistreatment. There is also confusion and debate over what constitutes elder mistreatment in older women versus what is domestic violence that has continued into later life. Professional nurses need to include both types of screening for their older female patients in order to address both types of family violence.

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