Hartford Institute for Geriatric Nursing eNewsletter
January 2009  
Greetings!

Welcome to the Hartford Institute for Geriatric Nursing's January 2009 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.

ConsultGeriRN.org is 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.

We would like to hear from you!

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.
 

Do You Know Enough About Treatment Decision Making and Older Adults?

Topic Content By:
Ethel L. Mitty and Linda Farber Post

Capable persons (i.e., those with decisional capacity) have a well-established right, grounded in law and Western bioethics, to determine what is done to their bodies. Determination of decision-making capacity is a compelling clinical issue because treatment and diagnostic interventions have the potential for significant benefit, burden, and/or risk. Honoring the decisions of a capable patient demonstrates respect for the person; honoring the decisions of a patient without capacity is an act of abandonment.

Even capable patients, including those who are elderly, easily confused, or from cultures that do not consider autonomy a central value, as well as patients with diminished or fluctuating capacity, may not be capable of or comfortable with exercising purely autonomous decision making. Care professionals have an obligation to be alert to questionable or fluctuating capacity both in patients who refuse and those who consent to recommended treatment. Capable individuals may choose to make their own care decisions or they may voluntarily delegate decision-making authority to trusted others. Delegation of decisional authority must be explicitly confirmed, not inferred.

Learn more about "Treatment Decision Making" with references and resources by visiting ConsultGeriRN.org.
 

Article on Alcohol Use and Older Adults featured in New York Times

On December 15th, a column entitled, "Query for Aging Patients: How Much Do You Drink?", written by Jane E. Brody, was published in the Personal Health section of the New York Times. The article addresses the fact that doctors rarely ask their older patients how much and how often they consume alcohol. Not knowing the answers to these questions can result in misdiagnosis, medical complications and life threatening accidents. The article also discusses whether there are benefits of moderate alcohol use for healthy older adults.

NYU College of Nursing Professor, Madeleine Naegle, APRN-BC, Ph.D., FAAN, was interviewed for the article. Dr. Naegle is the author of the "Alcohol Use Screening and Assessment" Try This issue, featured in the American Journal of Nursing's November installment of the How to Try This:® Series, a joint project with the Hartford Institute for Geriatric Nursing.
Read the full article.

You can also view the American Journal Nursing How to Try This article and video addressing this topic:

How To Try This (Article) - Screening for Alcohol Use and Misuse in Older Adults

How To Try This (Video) - The Short Michigan Alcohol Screening Instrument - Geriatric Version (SMAST-G)
 

How to Try This:® Series

The Modified Caregiver Strain Index

Topic Resources:
The Modified Caregiver Strain Index
  Article

The Modified Caregiver Strain Index
  Video
Videos can be watched in their entire format, or in chapters that relate to the specific assessment skills described above. Continuing education hours are also offered.
View more information about the series and topics covered.
The Modified Caregiver Strain Index can be given to family members caring for disabled older adults. It helps to determine their level of strain-a combination of stress and burden that has consequences on caregivers' overall health. The index assesses 13 aspects of physical health, family finances, social interactions, time demands, and employment. By pinpointing the sources and degree of strain, the index can guide in the selection of interventions that might be used to alleviate caregivers' strain and improve the lives of caregivers and care recipients.

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. View more information
 

Sound Off!

Older Adults With Trauma Are At Risk By Not Being Sent To A Trauma Center

Mathy Mezey Mathy Mezey, EdD, RN, FAAN
Professor and Director
Hartford Institute for Geriatric Nursing
New York University College of Nursing

Anecdotes are rampant about older people (as well as minority people) who have received what is universally considered inadequate care after a major car accident. A recent study confirms that older adults with trauma are half as likely, as compared to younger adults with similar conditions, to be transported to a state-designated trauma center (TC). Among the most common reasons given by EMS staff for failing to transport older adults to TCs were lack of training about elderly trauma, that such transport may "not be worth it" for older adults, and agreement that age bias may influence their decisions. If you work in a hospital with a TC you might consider what actions the hospital can take to assure that all patients with trauma, irrespective of age, reach their center and receive appropriate care. (Chang D, Bass R, Cornwell E, MacKenzie E (2008). "Undertriage of elderly trauma patients to State-designated trauma centers." Archives of Surgery 143:776-781)
 
NICHE: Nurses Improving Care for Healthsystem Elders Congratulations to Dr. Elizabeth Capezuti
It is our great pleasure to announce that Dr. Elizabeth Capezuti has been named the Dr John W. Rowe Professorship in Successful Aging, effective November 1, 2008. Dr. Capezuti was promoted to full professor at the New York University College of Nursing on September 1, 2008, and has worked tirelessly for the past five years to take the NICHE program to a new level of excellence. As one of the nation's leading authorities in gerontological nursing, the NICHE program is most fortunate to have Dr. Capezuti as its Co-Director. This chair will acknowledge Dr. Capezuti's academic leadership, excellence, and significant contributions in improving the quality of life for older adult patients.

2009 NICHE Audio Conference:
"Bridging the Great Divide: Retooling Your Performance Improvement Systems"
Wednesday January 28th, 2009 1:30-3:00 PM Eastern

Quality care for older adults has never been more important than in today's environment of public reporting and pay for performance. As of October 2008, Medicare will no longer pay for eight specific conditions including nosocomial pressure ulcers and fall related injuries in the hospital. Older adult hospitalized patients are especially at high risk for these conditions. Explore and discuss the challenges of measuring quality and how to develop strategies to address these specific organizational challenges.
  • PowerPoint presentations accompany each audio conference
  • Live Q&A session with the presenter
  • 1.5 Contact Hours
Register Today

 

Hartford Institute Geriatric Nursing Research Scholars Program: Call for Applications

The Hartford Institute will be hosting its annual week-long, intensive, summer seminar at New York University, July 13-17, 2009. The seminar is an in-depth mentoring experience with nationally recognized gerontologic nursing researchers. It is open to nurses who have completed an accredited doctoral degree and who wish to hone their research skills and advance their own program of research. Application deadline is April 8, 2009.
View more information

Or contact Deborah A. Chyun, PhD, RN, FAAN, at dc116@nyu.edu or 212.998.5264.

Link to ConsultGeriRN.org!
hartfordign.org nicheprogram.org consultgerirn.org
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