scholarly journals 77 Developing and Testing An Education-Career Pathway in Healthcare for Older People (ECHO) to Promote Retention in Early-Career Gerontological Nurses

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i25-i26
Author(s):  
C Naughton ◽  
I Ezhova ◽  
N Hayes ◽  
J Fitzpatrick
Keyword(s):  
Older People ◽  
Older Adult ◽  
Nurse Managers ◽  
Learning Opportunities ◽  
Early Career ◽  
Post Intervention ◽  
Multicomponent Intervention ◽  
Gerontological Nursing ◽  
Ethical Approval ◽  
Approach Working

Abstract Background The NHS Long Term Plan (2019) sets specific targets for multidisciplinary services for frail older people over the next ten years. Delivery and sustainability is crucially dependant on the capability and capacity of gerontological nursing. High cost cities such as London experience high staff vacancy rates in acute care older adult services. Aim The study took a regional approach, working with NHS Trusts to develop a multicomponent intervention to increase retention and competencies of early career nurses working in gerontological services. The study examined the acceptability and feasibility of the intervention and tested a quasi-experiential evaluation design. Ethical approval was obtained from the University Ethics committee. Methods A co-design approach with stakeholders, early career nurses, educationalists and nurse managers, produced a multicomponent intervention: education module (masters level), gerontological competency booklet, external clinical learning opportunities, career coaching and mentorship delivered over a six-month period. The evaluation involved a mix-methods pre-post survey and focus group interviews. Results Twenty-nine early career nurses were recruited from five Trusts. The multicomponent intervention was well received, but there were difficulties facilitating external learning opportunities and providing career mentors. The primary outcome was intention to remain in gerontological nursing (measured using a point Likert scale). Pre-post the intervention this remained high (mean score 6 IQR 5-7), p=0.78. There was a significant increase in gerontological knowledge: at baseline the median score was 87 (IQR 81-102) compared to 107 (IQR 98-112) post-intervention, p=0.006. In focus groups participants identified three main mechanism of action for ECHO: building gerontological knowledge and skills; professional identity as older adult nurse; and networking to broaden horizons. Conclusions The study has demonstrated the potential of Trusts to work collaboratively with education providers to deliver a model of career-education pathway that may help attract and retain early career nurses to work in gerontology.

The Surprise Question and Serious Illness Conversations: A pilot study

2021 ◽  
pp. 096973302098339
Author(s):  
Kathy Le ◽  
Jenny Lee ◽  
Sameer Desai ◽  
Anita Ho ◽  
Holly van Heukelom
Keyword(s):  
Pilot Study ◽  
Healthcare Professionals ◽  
Post Intervention ◽  
Acute Medicine ◽  
Serious Illness ◽  
Patient Goals ◽  
Ethical Approval ◽  
Seriously Ill Patients ◽  
Surprise Question ◽  
Seriously Ill

Background: Serious Illness Conversations aim to discuss patient goals. However, on acute medicine units, seriously ill patients may undergo distressing interventions until death. Objectives: To investigate the feasibility of using the Surprise Question, “Would you be surprised if this patient died within the next year?” to identify patients who would benefit from early Serious Illness Conversations and study any changes in the interdisciplinary team’s beliefs, confidence, and engagement as a result of asking the Surprise Question. Design: A prospective cohort pilot study with two Plan-Do-Study-Act cycles. Participants/context: Fifty-eight healthcare professionals working on Acute Medicine Units participated in pre- and post-intervention questionnaires. The intervention involved asking participants the Surprise Question for each patient. Patient charts were reviewed for Serious Illness Conversation documentation. Ethical considerations: Ethical approval was granted by the institutions involved. Findings: Equivocal overall changes in the beliefs, confidence, and engagement of healthcare professionals were observed. Six out of 23 patients were indicated as needing a Serious Illness Conversation; chart review provided some evidence that these patients had more Serious Illness Conversation documentation compared with the 17 patients not flagged for a Serious Illness Conversation. Issues were identified in equating the Surprise Question to a Serious Illness Conversation. Discussion: Appropriate support for seriously ill patients is both a nursing professional and ethical duty. Flagging patients for conversations may act as a filtering process, allowing healthcare professionals to focus on conversations with patients who need them most. There are ethical and practical issues as to what constitutes a “serious illness” and if answering “no” to the Surprise Question always equates to a conversation. Conclusion: The barriers of time constraints and lack of training call for institutional change in order to prioritise the moral obligation of Serious Illness Conversations.

The ‘loneliness pandemic’: implications for gerontological nursing

2021 ◽  
Vol 30 (11) ◽  
pp. 652-655
Author(s):  
Carlos Laranjeira
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Older People ◽  
Chronic Diseases ◽  
Old Age ◽  
Social Isolation ◽  
Social Relationships ◽  
Vulnerable Groups ◽  
Negative Consequences ◽  
Gerontological Nursing

The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.

Effects of CGA and multicomponent intervention on mobility of pre-frail and frail community-dwelling older people

2013 ◽  
Vol 4 ◽  
pp. S14
Author(s):  
P. Tikkanen ◽  
E. Lönnroos ◽  
S. Sipilä ◽  
I. Nykänen ◽  
R. Sulkava ◽  
...  
Keyword(s):  
Older People ◽  
Community Dwelling ◽  
Multicomponent Intervention ◽  
Community Dwelling Older People

A Ministry of Memory: Spiritual Care for the Older Adult With Dementia

2004 ◽  
Vol 5 (3) ◽  
pp. 183-187 ◽  
Author(s):  
Sharon Fish Mooney
Keyword(s):  
Older People ◽  
Older Adult ◽  
Spiritual Care ◽  
Cognitive Abilities ◽  
Elderly Persons ◽  
People With Dementia ◽  
Worship Services ◽  
Christian Worldview ◽  
Primary Focus ◽  
Progressive Cognitive Impairment

The primary focus of research related to spiritual and ministry needs of older people, historically and in the present, has been on those whose cognitive abilities are only minimally impaired. The older adult with a dementia like Alzheimer’s disease, however, has not received as much attention. This may be related to a lack of any theoretical framework from which to understand what may be happening to a markedly confused person spiritually, and how a person with progressive cognitive impairment might still be able to maintain a relationship with God and be ministered to by a God who may only be remembered vaguely, if at all. Elderly persons with dementia with a faith background rooted in the Judeo-Christian worldview are often able to respond to various rituals of their faith, verbally, physically, and emotionally. Common practices like familiar prayers, Bible readings, hymns, and attendance at worship services where collective memory is shared can serve as memory joggers to reconnect the person, not only to the faith community, but to a faithful God. A spiritual care ministry to older people with dementia can be considered a ministry of memory.

scholarly journals Preferences for Learning and Skill Development at Work: Comparison of Two Generations

2020 ◽  
Vol 5 (1) ◽  
pp. 169-186
Author(s):  
Mariya Karaivanova ◽  
Irina Zinovieva
Keyword(s):  
Older People ◽  
Labour Market ◽  
Skill Development ◽  
Age Groups ◽  
Learning Opportunities ◽  
Learning And Development ◽  
Predictive Capacity ◽  
Two Generations ◽  
Younger Generation ◽  
Work Preferences

The changing economic conditions of the current dynamic and insecure labour market make learning a constant preoccupation of the workforce with view of meeting the growing qualifi cation demands. These demands are likely to infl uence the work preferences of both young people now entering the labour market and older people with established career paths. Research fi ndings suggest that the younger generation exhibits a stronger orientation towards learning and skill development as compared to the older generations. Moreover, studies show that the younger people are more ready to leave the organization when they have better learning opportunities elsewhere. The present study aims at establishing how preferences for learning and skill development in the workplace relate to a number of job and organizational characteristics. Particular focus is placed on the predictive capacity of perceived learning opportunities towards the tendency to leave the organization for either of the two generations. The study addresses work preferences of two generations in the Bulgarian labour market. To this aim, 121 respondents answered a55-item questionnaire consisting of newly developed scales as well as scales based on or adopted from standardized instruments such as the Extended Delft Measurement Kit (Roe et al., 2000). Contrary to fi ndings from previous research done in countries with different cultural and socio-economic background, the older people in our sample were more eager to learn and more ready to leave their organization in pursuit of better opportunities, ascompared to the younger generation. Another noteworthy conclusion is that the preferences for learning and development form different patterns in each of the two age groups and are expressed in a different way for each of the two generations.

scholarly journals Technology implementation in delivery of healthcare to older people: how can the least voiced in society be heard?

2018 ◽  
Vol 12 (2) ◽  
pp. 76-90 ◽  
Author(s):  
Yvonne van Zaalen ◽  
Mary McDonnell ◽  
Barbara Mikołajczyk ◽  
Sandra Buttigieg ◽  
Maria del Carmen Requena ◽  
...  
Keyword(s):  
Older Adults ◽  
Older People ◽  
Older Adult ◽  
Social Relations ◽  
Technology Use ◽  
Great Emphasis ◽  
Older Person ◽  
Content Type ◽  
Mediating Role ◽  
Use Of Technology

PurposeThe purpose of this paper is to focus on ethical and judicial themes related to technology and the older adults.Design/methodology/approachDifferent consecutive phases in technology design and allocation will be discussed from a range of perspectives.FindingsLongevity is one of the greatest achievements of contemporary science and a result of development of social relations. Currently, various non-communicable diseases affect older adults and impose the greatest burden on global health. There is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for good quality of life (QOL). The concept of assisting the older adult through the use of technology so as to access healthcare services has enormous potential. Although the potential of technology in healthcare is widely recognised, technology use can have its downsides. Professionals need to be aware of the risks, namely, those related to the privacy of the older person, which may accompany technology use.Research limitations/implicationsBy 2050, there will be more people aged over 65 than there are children. This phenomenon of global ageing constitutes a massive challenge in the area of health protection.Practical implicationsProfessionals need to be aware of the risks, for example, related to the privacy of the older person, that may accompany technology use.Social implicationsThere is a great emphasis across Europe on caring for the older person in their own homes. Technology has a mediating role in determining the possibilities for QOL.Originality/valueThe concept of assisting the older adult through the use of technology to avail of healthcare has enormous potential. Assistive technology, social media use and augmentative and alternative communication can have a positive effect on the QOL of older people, as long as they are supported enough in use of these technologies. However, ethical and juridical considerations are at stake as well.

Clinical supervision in older adult mental health services

2019 ◽  
Vol 23 (4) ◽  
pp. 241-250
Author(s):  
Alessandra Merizzi
Keyword(s):  
Older Adults ◽  
Older People ◽  
Older Adult ◽  
Clinical Supervision ◽  
Health Care Professionals ◽  
Theoretical Models ◽  
Clinical Work ◽  
Therapeutic Work ◽  
Content Type ◽  
Self Reflection

Purpose The purpose of this paper is to explore how supervision is applied in the context of National Health Service services for older adults, with particular regard to the profession of clinical psychology and psychotherapy. Design/methodology/approach The clinical supervision theories that are considered in this exploration are the Seven-Eyed Model (Hawkins and Shohet, 2012) and the Cyclical Model (Page and Wosket, 2015). The discussion also integrates an overview of psychological dynamics as presented by the existing literature with the author’s reflections on the influence of ageing stereotypes in the therapeutic work with older adults. Findings The theoretical models of clinical supervision considered can offer a robust framework and pathway for supervisory work in psychology and psychotherapy for older people. However, this alone seems insufficient and needs to be combined with the supervisor’s knowledge on psychology of ageing as well as their own self-reflection on internalised ageing stereotypes. Practical implications The paper suggests a need for health care professionals, providing clinical supervision on older adult therapeutic work, to be familiar with the aspects analysed. Originality/value Clinical supervision handbooks overlook aspects related to age as an issue of difference. This paper adds value to the clinical work with older people through a novel attempt to link implications of ageing stereotypes with the therapeutic and supervisory practice.

scholarly journals Involving older people in gerontological nursing research: A discussion of five European perspectives

2020 ◽  
Vol 15 (2) ◽  
Author(s):  
Emma Pascale Blakey ◽  
Angela Durante ◽  
Simon Malfait ◽  
Kalatzi Panayiota ◽  
Friederike J. S. Thilo ◽  
...  
Keyword(s):  
Older People ◽  
Nursing Research ◽  
Gerontological Nursing

scholarly journals Older people’s perceived autonomy in residential care: An integrative review

2020 ◽  
pp. 096973302094811
Author(s):  
Tanja Moilanen ◽  
Mari Kangasniemi ◽  
Oili Papinaho ◽  
Mari Mynttinen ◽  
Helena Siipi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Residential Care ◽  
Personal Characteristics ◽  
Comparison Method ◽  
Integrative Review ◽  
Care Needs ◽  
Mental Competence ◽  
Ethical Approval

Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people’s perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher’s Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people’s individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples’ autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people’s choices. Professionals’ characteristics, such as education and attitudes, and the older people’s living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people’s perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.

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