Greetings!

Welcome to the Hartford Institute for Geriatric Nursing's July 2008 eNewsletter featuring articles, reference materials, useful links, calendar of events and other best practice information on the care of older adults.

This eNewsletter is sponsored by ConsultGeriRN.org, the authoritative geriatric clinical nursing website of the Hartford Institute for Geriatric Nursing, New York University College of Nursing and the NICHE (Nurses Improving Care for HealthSystem Elders) program, (www.nicheprogram.org). ConsultGeriRN.org contains evidence-based protocols and topics for nurses and other healthcare professionals on the care of older adults. Content is updated regularly.

Guiding Principles regarding Advance Directives:

•  All people have the right to decide what will be done with their bodies
•  All individuals are presumed to have decision-making capacity until deemed otherwise
•  All patients who can participate in a conversation, either verbally or through an alternate means of communication, should be approached to discuss and record their treatment preferences and wishes
•  Health care professionals can improve end-of-life care for elderly patients by encouraging the use of ADs

Learn more about this topic and the resources available on the assessment and care strategies associated with Advance Directives.

NICHE (Nurses Improving Care in HealthSystem Elders) Site Coordinator Rita La Rue, MSN, APRN, BC, GNP from Bronson Methodist Hospital, Kalamazoo, MI co-authored the featured article "Examining the Feasibility of Implementing Specific Nursing Interventions to Promote Sleep in Hospitalized Elderly Patients". "Quality of Geriatric Care Strengthened by NICHE Program", an article co-authored by Dr. Marie Boltz, NICHE Practice Director, PhD, RN, GNP, BC and colleagues, was prominently featured on this issues' cover. Get a free copy of the article

Also featured in this issue is an Assisted Living Column co-authored by Ethel Mitty, EdD, RN, Adjunct Clinical Prof. NYU College of Nursing, and Sandi Flores, RN, C, founder of American Assisted Living Nurses Assoc, Ed. Director, Community Education LLC. The column entitled "Suicide in Late Life" addresses the startling statistics on suicide in older adults, the risk factors, and the role of depression. Basic screening tools and supportive actions are also included.

This Month's Topic: Using Pain-Rating Scales with Older Adults
Pain is often undertreated and underdiagnosed in older adults. Regular use of short, simple, reliable pain-rating scales provides nurses and physicians with measurable information to establish and modify a pain management plan. This article describes the use of three widely used pain-rating scales: the numeric rating scale, the verbal descriptor scale, and the Faces Pain Scale - Revised.

Video for this topic includes demonstrations of how to assess for pain in any older adult, and to reassess to determine the effectiveness of interventions, using four distinct tools: the Faces Pain Scale, the Verbal Descriptor Scale, the Numeric Rating Scale, and the Pain Assessment in Advanced Dementia Scale (PAINAD).
View more information

The How to Try This series is funded by the John A. Hartford Foundation to the Hartford Institute for Geriatric Nursing at New York University's College of Nursing in collaboration with the American Journal of Nursing (AJN). This initiative translates the evidence-based geriatric assessment tools in the Try This Assessment Series into cost-free, web-based print and video resources, for caring for older adults. This series can be viewed, downloaded, and shared without any fees. Articles may be printed and copied for educational use without copyright fees.
You can also read more about the topic 'Pain' on ConsultGeriRN.org.

By Sarah Greene Burger, RN-C, MPH, FAAN
Senior Advisor on Special Projects, Hartford Institute

The Institute of Medicine's timely report, Retooling for an Aging America: Building the Health Care Workforce, addresses the health needs of the baby boomer generation through 2030 when the over 65 population will double from 37 million in 2005 to over 70 million. The committee, which included NYU College of Nursing's Dean, Terry Fulmer, concludes that to meet the challenge, the definition of workforce must expand to include everyone in each patient's care: health care professionals, direct-care workers, informal caregivers and the patients themselves. The committee proposes a three pronged approach:

• Enhance the geriatric competence of the entire workforce
• Increase the recruitment and retention of geriatric specialists and caregivers
• Improve the way care is given

For a free copy of the report visit www.nap.edu and click on "Medicine".

Atlantic Philanthropies and the John A Hartford Foundation are funding exploration of a broad based Alliance of workers, professionals, and consumer and provider associations to respond to the IOM Workforce recommendations. The American Geriatrics Society convened professional and paraprofessional organizations to explore a response to the IOM recommendations. The Hartford Institute and the Coalition of Geriatric Nursing Organizations had representatives at both meetings. Contact sgburger@rcn.com for information.

Add a link on your site to ConsultGeriRN.org! Free banner ads and other marketing materials are now available on ConsultGeriRN.org.

If you have a geriatric-related story, topic or an event you would like featured in our newsletter, please send your request to editor@consultgerirn.org.