How Care Coordinators and Other Nursing Professionals Can Help Optimize Care of Asthma in Older Adults

2019 ◽  
pp. 101-111
Author(s):  
Cheryl K. Bernstein ◽  
Concettina Tolomeo
Keyword(s):  
Older Adults ◽  
Care Coordinators ◽  
Nursing Professionals

scholarly journals Spreading Telehealth for Older Adults in Rural Areas Through Network of Geriatric Interprofessional Teams

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 796-796
Author(s):  
Steven Barczi ◽  
Megan Gately ◽  
Lauren Welch ◽  
Kathryn Nearing ◽  
Stephen Thielke ◽  
...  
Keyword(s):  
Older Adults ◽  
Rural Areas ◽  
Urban Areas ◽  
Care Needs ◽  
Community Based ◽  
Team Care ◽  
Geriatric Consultation ◽  
Complex Care Needs ◽  
Nursing Professionals ◽  
Community Based Services

Abstract Older adults living in rural areas have limited access to geriatrics interprofessional team care. In the Veteran healthcare system, geriatric teams such as geriatricians, nursing professionals, social workers, pharmacists and psychologists, located in urban areas link up with rural clinics to provide geriatric consultation remotely through clinical video telehealth and other means in the project GRECC Connect. Since its inception in 2014, the service has now grown to 16 geriatric teams offering consultation to over 100 clinic sites serving older rural Veterans. GRECC Connect delivered over 2,000 consultations in 2019, meeting complex care needs by identifying and linking geriatric services and management to patients with geriatric syndromes. The network of established geriatric teams, local champions and a shared Electronic Health Record facilitated the spread, while ongoing effort to build and maintain relationships between consultants and local rural provider teams and other community based services are important for ongoing success.

scholarly journals The Myth of Care Coordination: Whether Professional Care Coordination Improved Older Adults’ Health Outcomes?

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 1058-1058
Author(s):  
Kedong Ding
Keyword(s):  
Older Adults ◽  
Health Service ◽  
Health Outcomes ◽  
Physical Health ◽  
Service Utilization ◽  
Care Coordination ◽  
Health Service Utilization ◽  
Care Coordinators ◽  
Professional Care ◽  
Multidimensional Health

Abstract Background Current evidence on the effects of Care Coordination (CC) on older adults’ well-being and health service utilization is inconsistent. Previous studies are mostly limited to regional data and focus mostly on nurse-led CC instead of layperson Care Coordinators like family caregivers. This study explores the effects of having CC in a national sample of U.S. older adults and whether the coordinators’ professionalism impacts the effect of having CC on multidimensional health outcomes (Health outcomes were conceptualized as physical health, healthcare utilization, and care encounters). Methods Data were from the 2016 and 2018 waves of the Health and Retirement Study (HRS) (n=1,372). Multivariate regression models were used to examine the effects of CC on multidimensional health outcomes in 2016 and the longitudinal effects of having CC. We also tested the effect of Care Coordinators’ professionalism on the multidimensional health outcomes. All models controlled for sociodemographic characteristics and health status. Results Findings suggest that having CC doesn’t have a positive effect on older adults’ health outcomes. Having CC was associated with an increased number of acute diseases (β = 0.16, p < .001) and nonacute diseases (β = 0.21, p < .01) in longterm. The results regarding cross-sectional effects show that receiving care from a Coordinator was related to increased health service utilization. Participants with professional Care Coordinators were more likely to report receiving person-centered care (OR=1.60, p<.05). Conclusion This study demonstrates the limited effects of CCs on older adults’ physical health outcomes, and emphasized the importance of care coordinators’ qualifications.

scholarly journals Profiling Patient Characteristics Associated With the Intensity of Nurse Care Coordination

2016 ◽  
Vol 39 (1) ◽  
pp. 186-203
Author(s):  
Tae Youn Kim ◽  
Karen D. Marek
Keyword(s):  
Older Adults ◽  
Health Status ◽  
Patient Characteristics ◽  
Chronically Ill ◽  
Community Dwelling ◽  
Physical And Mental Health ◽  
Medication Regimen ◽  
Nurse Care ◽  
Medication Regimen Complexity ◽  
Care Coordinators

The purpose of this study was to identify characteristics of chronically ill community-dwelling older adults that differentiate the intensity of care provided by nurse care coordinators. We performed data mining on electronic health records, nurses’ activity logs, and health status measures from 784 care episodes provided to 196 older adults. An inductively created decision tree identified nine groups from a combination of the six participant characteristics including medication regimen complexity, cognition, physical and mental health, hospital admission, and physical functioning. Overall there was a 5-hr difference in the intensity (or contact hours) per quarter of nurse care coordinators between individuals in the highest versus lowest intensity groups. The highest intensity group presented higher medication complexity and lower mental/physical health status. With caseloads of 30 to 35 participants, nurse care coordinators were able to provide care based on participant needs that were not influenced by regulatory payment requirements.

scholarly journals Programmed home visits by nursing professionals to older adults: prevention or treatment?

2015 ◽  
Vol 23 (3) ◽  
pp. 535-542 ◽  
Author(s):  
Caridad Dios-Guerra ◽  
Juan Manuel Carmona-Torres ◽  
África Ruíz-Gándara ◽  
Adoración Muñoz-Alonso ◽  
María-Aurora Rodríguez-Borrego
Keyword(s):  
Older Adults ◽  
Home Visits ◽  
Nursing Professionals

OBJETIVOS: conocer la repercusión de la visita domiciliaria de los profesionales en enfermería a personas de 65 años o más, pluripatológicas, en morbimortalidad.MÉTODO: estudio retrospectivo caso-control por auditoria de historias clínicas. Muestreo aleatorio. Variables principales morbilidad, mortalidad; descriptivas: visitas de la enfermera, filiación, datos clínicos y socio sanitarios. Análisis por medidas de tendencia central, dispersión, posición, tabulación, frecuencias relativas, absolutas; no paramétricas, contrastes χ2; Wilcoxon-Mann-Whitney.RESULTADOS: se estudiaron a 1743 pacientes, de ellos 199 recibieron visita domiciliaria; la edad media de quien recibe visita es de 81,99 años; estos presentan mayor número de patologías de media 3,76; habitan en domicilio particular, si bien en conjunto presentan más institucionalización que los controles; el 50% no tiene identificado el Cuidador Principal; es mayor el número de visitas de las enfermeras a los pacientes que viven en residencias (p < 0,001). El 50% de casos no tiene plan de cuidados, con relación significativa (p < 0,001). No existen diferencias significativas en tiempo de vida entre los casos y los controles.CONCLUSIÓN: la visita domiciliaria del profesional en enfermería no repercute en la morbimortalidad; visita a los pacientes cuando ya ha aparecido el problema de salud, no hay datos de prevención.

scholarly journals CHANGING NURSES’ BEHAVIOR TOWARD NUTRITIONAL CARE WITH A SNACK-SIZED LEARNING INTERVENTION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S47-S47
Author(s):  
Debbie Ten Cate ◽  
Jeroen Dikken ◽  
Roelof Ettema ◽  
Lisette Schoonhoven ◽  
Marieke J Schuurmans
Keyword(s):  
Older Adults ◽  
Nursing Students ◽  
Content Validity ◽  
Nutritional Care ◽  
Learning Intervention ◽  
Prevention And Treatment ◽  
Nursing Professionals ◽  
Motivation To Give

Abstract Nurses play an important role in the prevention and treatment of malnutrition in older adults. However, research shows that nurses lack the motivation to give adequate nutritional care. In order to change this motivation a learning intervention about nutrition in older adults targeted at nurses would be desirable. The aim of this study was to assess the development, validation, and reliability of a learning intervention about nutrition in older adults. The results show that this learning intervention has a good construct and content validity, and is psychometrically sound. Questions of the learning intervention can be presented at once or in a snack-sized way, where the questions are presented over a period of time. This learning intervention can be used for developers of similar interventions, and as part of educating programs for nursing professionals and nursing students about nutritional care for older adults.

Cognitive control constrains memory attributions

2019 ◽  
Vol 42 ◽  
Author(s):  
Colleen M. Kelley ◽  
Larry L. Jacoby
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Cognitive Control

Abstract Cognitive control constrains retrieval processing and so restricts what comes to mind as input to the attribution system. We review evidence that older adults, patients with Alzheimer's disease, and people with traumatic brain injury exert less cognitive control during retrieval, and so are susceptible to memory misattributions in the form of dramatic levels of false remembering.

Cognitive Load Affects Speech Motor Performance Differently in Older and Younger Adults

2019 ◽  
Vol 62 (5) ◽  
pp. 1258-1277 ◽  
Author(s):  
Megan K. MacPherson
Keyword(s):  
Older Adults ◽  
Cognitive Load ◽  
Motor Performance ◽  
Age Groups ◽  
Incongruent Condition ◽  
Sentence Production ◽  
Movement Duration ◽  
Production Task ◽  
Younger Adults ◽  
Speech Motor

PurposeThe aim of this study was to determine the impact of cognitive load imposed by a speech production task on the speech motor performance of healthy older and younger adults. Response inhibition, selective attention, and working memory were the primary cognitive processes of interest.MethodTwelve healthy older and 12 healthy younger adults produced multiple repetitions of 4 sentences containing an embedded Stroop task in 2 cognitive load conditions: congruent and incongruent. The incongruent condition, which required participants to suppress orthographic information to say the font colors in which color words were written, represented an increase in cognitive load relative to the congruent condition in which word text and font color matched. Kinematic measures of articulatory coordination variability and movement duration as well as a behavioral measure of sentence production accuracy were compared between groups and conditions and across 3 sentence segments (pre-, during-, and post-Stroop).ResultsIncreased cognitive load in the incongruent condition was associated with increased articulatory coordination variability and movement duration, compared to the congruent Stroop condition, for both age groups. Overall, the effect of increased cognitive load was greater for older adults than younger adults and was greatest in the portion of the sentence in which cognitive load was manipulated (during-Stroop), followed by the pre-Stroop segment. Sentence production accuracy was reduced for older adults in the incongruent condition.ConclusionsIncreased cognitive load involving response inhibition, selective attention, and working memory processes within a speech production task disrupted both the stability and timing with which speech was produced by both age groups. Older adults' speech motor performance may have been more affected due to age-related changes in cognitive and motoric functions that result in altered motor cognition.

Effects of Aging on the Subcortical Encoding of Stop Consonants

2020 ◽  
Vol 29 (3) ◽  
pp. 391-403
Author(s):  
Dania Rishiq ◽  
Ashley Harkrider ◽  
Cary Springer ◽  
Mark Hedrick
Keyword(s):  
Older Adults ◽  
Repeated Measures ◽  
Mixed Model ◽  
Auditory Brainstem ◽  
Auditory Brainstem Responses ◽  
Aging Effects ◽  
Formant Frequency ◽  
Place Of Articulation ◽  
Second Formant ◽  
Effects Of Aging

Purpose The main purpose of this study was to evaluate aging effects on the predominantly subcortical (brainstem) encoding of the second-formant frequency transition, an essential acoustic cue for perceiving place of articulation. Method Synthetic consonant–vowel syllables varying in second-formant onset frequency (i.e., /ba/, /da/, and /ga/ stimuli) were used to elicit speech-evoked auditory brainstem responses (speech-ABRs) in 16 young adults ( M age = 21 years) and 11 older adults ( M age = 59 years). Repeated-measures mixed-model analyses of variance were performed on the latencies and amplitudes of the speech-ABR peaks. Fixed factors were phoneme (repeated measures on three levels: /b/ vs. /d/ vs. /g/) and age (two levels: young vs. older). Results Speech-ABR differences were observed between the two groups (young vs. older adults). Specifically, older listeners showed generalized amplitude reductions for onset and major peaks. Significant Phoneme × Group interactions were not observed. Conclusions Results showed aging effects in speech-ABR amplitudes that may reflect diminished subcortical encoding of consonants in older listeners. These aging effects were not phoneme dependent as observed using the statistical methods of this study.

Partner-Specific Communication Deficits in Individuals With Alzheimer's Disease

2020 ◽  
pp. 1-15
Author(s):  
Eun Jin Paek ◽  
Si On Yoon
Keyword(s):  
Alzheimer’S Disease ◽  
Older Adults ◽  
Alzheimer's Disease ◽  
Referential Communication ◽  
Sorting Task ◽  
Audience Design ◽  
Healthy Older Adults ◽  
Communication Task ◽  
Design Skills ◽  
Referential Expressions

Purpose Speakers adjust referential expressions to the listeners' knowledge while communicating, a phenomenon called “audience design.” While individuals with Alzheimer's disease (AD) show difficulties in discourse production, it is unclear whether they exhibit preserved partner-specific audience design. The current study examined if individuals with AD demonstrate partner-specific audience design skills. Method Ten adults with mild-to-moderate AD and 12 healthy older adults performed a referential communication task with two experimenters (E1 and E2). At first, E1 and participants completed an image-sorting task, allowing them to establish shared labels. Then, during testing, both experimenters were present in the room, and participants described images to either E1 or E2 (randomly alternating). Analyses focused on the number of words participants used to describe each image and whether they reused shared labels. Results During testing, participants in both groups produced shorter descriptions when describing familiar images versus new images, demonstrating their ability to learn novel knowledge. When they described familiar images, healthy older adults modified their expressions depending on the current partner's knowledge, producing shorter expressions and more established labels for the knowledgeable partner (E1) versus the naïve partner (E2), but individuals with AD were less likely to do so. Conclusions The current study revealed that both individuals with AD and the control participants were able to acquire novel knowledge, but individuals with AD tended not to flexibly adjust expressions depending on the partner's knowledge state. Conversational inefficiency and difficulties observed in AD may, in part, stem from disrupted audience design skills.

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