The use of analgesics and associated factors among nursing home residents

Aim: This study examined the use of analgesics and associated factors among nursing home residents (NHRs). Materials & methods: A descriptive correlational design and a convenience sample of 209 NHRs receiving analgesics was used in this study. Results: Higher use of analgesics was noted among NHRs without cognitive impairment (p < 0.001), those with higher anticholinergic burden scores (p = 0.002) and those with a higher average number of oral pills taken daily (p = 0.045). Conclusion: These findings contribute to a better understanding of the prevalence and associated factors of analgesic use, which will inform the development and application of evidence-based pain practice and guidelines in nursing homes in Jordan and beyond.

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Anticholinergic burden and risk of cognitive impairment in elderly nursing home residents with depression

Research in Social and Administrative Pharmacy ◽

10.1016/j.sapharm.2019.05.020 ◽

2020 ◽

Vol 16 (3) ◽

pp. 329-335 ◽

Cited By ~ 2

Author(s):

Satabdi Chatterjee ◽

Vishal Bali ◽

Ryan M. Carnahan ◽

Hua Chen ◽

Michael L. Johnson ◽

...

Keyword(s):

Nursing Home ◽

Cognitive Impairment ◽

Nursing Home Residents ◽

Anticholinergic Burden

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Nurses’ certainty and pain outcomes of nursing home residents with dementia: the mediating effect of pain assessment

Pain Management ◽

10.2217/pmt-2019-0027 ◽

2019 ◽

Vol 9 (6) ◽

pp. 559-567

Author(s):

Mohammad Rababa ◽

Sami Al-Rawashdeh

Keyword(s):

Nursing Home ◽

Patient Outcomes ◽

Pain Assessment ◽

Nursing Home Residents ◽

Mediating Effect ◽

Self Report ◽

Convenience Sample ◽

Correlational Design ◽

Pain Outcomes ◽

Severity Of Dementia

Aim: This study aims to examine the associations of pain assessment scope, nurses’ certainty, patient outcomes, and cognitive and verbal characteristics of nursing home (NH) residents. Methods: This study used a descriptive correlational design and a convenience sample of 78 NH residents with dementia. Results: There are significant associations between the severity of dementia and the ability to self report symptoms in NH residents and nurses’ certainty of pain. Also, pain assessment scope does not mediate the relationship between nurses’ certainty and patient outcomes. Conclusion: Pain assessment in NH residents with dementia is very challenging for nurses due to multiple complex factors. Improved understanding of pain assessment in those residents and how it relates to certainty of pain and patient outcomes are crucial.

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Responding to Varying Levels of Certainty about Pain in People with Dementia after Initial Pain Assessment

Dementia and Geriatric Cognitive Disorders Extra ◽

10.1159/000501030 ◽

2019 ◽

Vol 9 (2) ◽

pp. 271-280

Author(s):

Mohammad Rababa ◽

Mohammed Aldalaykeh

Keyword(s):

Nursing Home ◽

Pain Management ◽

Patient Outcomes ◽

Pain Assessment ◽

Nursing Home Residents ◽

Related Factors ◽

Convenience Sample ◽

Correlational Design ◽

People With Dementia ◽

The Relationship

Introduction: Pain is still inadequately treated in people with dementia (PWD) due to the complexity of assessing it. Pain assessment in PWD is still challenging because of patient-related or nurse-related factors. The patient-related factors have been studied extensively. However, the nurse-related factors, e.g., nurses’ certainty regarding suspected pain in PWD, have been given little attention by researchers. Purpose: This study aims to investigate how the degree of nurses’ certainty is compromised after pain assessment and how this affects levels of pain and agitation in PWD. Method: A descriptive, correlational design was used, and a convenience sample of 104 nursing home residents with dementia were recruited. Results: This study found that nurses’ certainty after the pain assessment mediates the relationship between the type of pain assessment and patient outcomes when the nurses had a high initial certainty. When nurses had a low initial certainty, their certainty after the assessment and the type of assessment predicted the levels of pain and agitation in PWD. Conclusion: Understanding how nurses’ certainty can be compromising after pain assessment and how this relates to pain management in PWD is crucial.

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Disruptive Vocalization and Depression in Older Nursing Home Residents

International Psychogeriatrics ◽

10.1017/s104161020000658x ◽

2000 ◽

Vol 12 (4) ◽

pp. 463-471 ◽

Cited By ~ 27

Author(s):

Michael Dwyer ◽

Gerard J. A. Byrne

Keyword(s):

Nursing Home ◽

Cognitive Impairment ◽

Depressive Symptoms ◽

Mini Mental State Examination ◽

Mmse Score ◽

Nursing Home Residents ◽

Confounding Variables ◽

The Relationship ◽

State Examination ◽

Age And Sex

Screaming and other types of disruptive vocalization are commonly observed among nursing home residents. Depressive symptoms are also frequently seen in this group, although the relationship between disruptive vocalization and depressive symptoms is unclear. Accordingly, we sought to examine this relationship in older nursing home residents. We undertook a controlled comparison of 41 vocally disruptive nursing home residents and 43 non-vocally-disruptive nursing home residents. All participants were selected to have Mini-Mental State Examination (MMSE) scores of at least 10. Participants had a mean age of 81.0 years (range 63-97 years) and had a mean MMSE score of 17.8 (range 10-29). Nurse ratings of disruptive vocalization according to a semioperationalized definition were validated against the noisy behavior subscale of the Cohen-Mansfield Agitation Inventory. Subjects were independently rated for depressive symptoms by a psychiatrist using the Dementia Mood Assessment Scale, the Cornell Scale for Depression in Dementia, and the Depressive Signs Scale. Vocally disruptive nursing home residents scored significantly higher than controls on each of these three depresion-in-dementia scales. These differences remained significant when the effects of possible confounding variables of cognitive impairment, age, and sex were removed. We conclude that depressive symptoms are associated with disruptive vocalization and may have an etiological role in the generation of disruptive vocalization behaviors in elderly nursing home residents.

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Advanced cognitive impairment among older nursing home residents

BMC Geriatrics ◽

10.1186/s12877-021-02336-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tadeja Gracner ◽

Patricia W. Stone ◽

Mansi Agarwal ◽

Mark Sorbero ◽

Susan L Mitchell ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Nursing Home ◽

Cognitive Impairment ◽

Mortality Risk ◽

Advanced Disease ◽

Nursing Home Residents ◽

Functional Score ◽

Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

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Feasibility of the cognitive assessment of nursing home residents with mild-to-moderate cognitive impairment using the intelligent voice-guided digital assistant THALIE: A pilot study

Gerontechnology ◽

10.4017/gt.2020.19.04.390 ◽

2020 ◽

Vol 19 (4) ◽

pp. 1-9

Author(s):

Patricia Sagaspe ◽

Véronique Lespinet-Najib ◽

Sylvie Poulette ◽

Jean-Christophe Vasselon ◽

Amélie Roche ◽

...

Keyword(s):

Nursing Home ◽

Cognitive Impairment ◽

Pilot Study ◽

Cognitive Assessment ◽

Nursing Home Residents ◽

Moderate Cognitive Impairment

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Factors Influencing the Deterioration from Cognitive Decline of Normal Aging to Dementia among Nursing Home Residents

10.21203/rs.3.rs-42680/v2 ◽

2020 ◽

Author(s):

Audai A. Hayajneh ◽

Mohammad Rababa ◽

Alia A. Alghwiri ◽

Dina Masha'al

Keyword(s):

Quality Of Life ◽

Nursing Home ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Nursing Homes ◽

Nursing Home Residents ◽

Bivariate Analysis ◽

Medical Factors ◽

Moderate Cognitive Impairment

Abstract Background: A dearth of differential research exists regarding the determinants of mild cognitive impairment (MCI) and moderate cognitive impairment or dementia among nursing home residents. This study aimed to identify and examine the association between medical factors (number of comorbidities, hospitalization, disability, depression, frailty and quality of life) and moderate cognitive impairment or dementia in nursing homes residents.Methods: A cross-sectional design was used in this study. Convenience sampling of 182 participants was conducted in nursing homes located in the central part of Jordan. Montreal cognitive assessment (MoCA) was used to screen both MCI and moderate cognitive impairment or dementia. Bivariate analysis, including t-test and ANOVA test, and logistic and linear regression models were used to examine and identify the medical factors associated with moderate cognitive impairment or dementia compared to mild cognitive impairment.Results: Most nursing home residents had MCI (87.4%) compared to a few with moderate cognitive impairment or dementia. Age (t = -2.773), number of comorbidities (t = -4.045), depression (t = -4.809), frailty (t = -4.038), and quality of life physical (t = 3.282) and mental component summaries (t = 2.469) were significantly different between the stages of cognitive impairment. Marital status (t = -4.050, p < 0.001), higher-income (t = 3.755, p < 0.001), recent hospitalization (t = 2.622,p = 0.01), depression (t = -2.737, p = 0.007), and frailty (t = 2.852, p = 0.005) were significantly associated with mental ability scores among nursing home residents.Conclusion: The coexistence of comorbidities and depression among nursing home residents with MCI necessitates prompt management by healthcare providers to combat depressive symptoms in order to delay the dementia trajectory among at-risk residents.Trail registration number: ClinicalTrials.gov Identifier: NCT04589637

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