Greetings!

Welcome to the Hartford Institute for Geriatric Nursing's April 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!

Try This:® a publication of the Hartford Institute for Geriatric Nursing, is a series of assessment tools and best practice approaches to care where each issue focuses on a topic specific to the older adult population. "The Transitional Care Model (TCM): Hospital Discharge Screening Criteria for High Risk Older Adults" authored by M. Brian Bixby and Mary D. Naylor from the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, describes how to identify patients at high risk for poor outcomes after hospitalization for an acute or exacerbated chronic illness. This best practice approach to care highlights those screening criteria, that if positive, should trigger the nurse to implement post-discharge interventions to assure appropriate information transfer and follow-up after discharge to home or other care setting.
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View the entire Try This:® series

Twenty-eight national nursing organizations, including twenty-one specialty associations and seven members of the Coalition of Geriatric Nursing Organizations (CGNO) have endorsed the Specialty Nursing Association Global Vision Statement on Care of Older Adults, as of March 30, 2009. The statement emphasizes that, with the rapid increase in the population of U.S. older-adults, the nurse workforce must become equipped to meet their changing and specific health care needs. Older adults constitute the largest group of health care users across all settings, and virtually all nurses care for older adults in their subspecialties. Nurses must be competent to deliver care to older adults, being sensitive to the physiological, functional, and psychological needs that set them apart from younger adults. Learn more about the Global Vision Statement on ConsultGeriRN.org

Although it is generally believed that sexual desires decrease with age, several researchers have identified that sexual desires, thoughts, and actions continue throughout all decades of life. Human touch and healthy sex lives evoke sentiments of joy, romance, affection, passion, and intimacy, whereas despondency and depression often result from an inability to express one's sexuality. Health care providers play an important role in assessing and managing normal and pathological aging changes in order to improve the sexual health of older adults. Learn more about "Sexuality Issues in Aging" with references and resources by visiting ConsultGeriRN.org.

NICHE Web Based Learning Series Presents:

"The Never Event Series: The Experts Respond"

A person may suffer debilitating anxiety and other physical and psychological symptoms without recognizing that they're a response to a traumatic event. And older adults in particular may be reluctant to admit to experiencing such symptoms. The Impact of Event Scale-Revised (IES-R) is an easy-to-administer questionnaire used to evaluate the degree of distress a patient feels in response to trauma. It provides a structured way for a patient to communicate distress when she or he may not have the words to do so.

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

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

Through a grant from The Commonwealth Fund, Quality Partners of Rhode Island in collaboration with B & F Consulting recently created a useful tool for nursing home leadership - The Workforce Stability Toolkit . This toolkit incorporates experiences and lessons learned in over 400 nursing homes. It is designed to serve as a resource for homes just getting started with efforts to reverse turnover as well as employers who have already started to address recruitment and retention and need further assistance in a specific area. The toolkit applies concepts and practices based on the work of Susan Eaton, Ph.D. who, in 2002, completed a CMS funded study, What a Difference Management Makes!

This Workforce Stability Toolkit is being offered to nursing homes free of charge and is available for interested parties to view, print and save for future use. Learn more about the Workforce Stability Toolkit - A Publication From Quality Partners of Rhode Island.

For more information about this toolkit, contact Gail Patry: gpatry@riquio.spds.org

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

Nurses are accustomed to caring for older adults with clearly diagnosed dementias whose memory loss, inability to find words, and difficulty with eating, dressing and toileting are quite apparent. But a special issue of the March 2009 Journal of Gerontological Nursing emphasizes the good outcomes that nurses can achieve by identifying older adults with early-stage Alzheimer's dementia. Early-stage dementia, a relatively new term, characterizes people with low normal or barely abnormal scores on instruments that assess cognition and dementia (e.g. the Global Deterioration Scale [GDS]), who are aware of a difficulty but are still able to actively participate in healthcare decisions. The earlier the dementia is diagnosed, the better the response to pharmacological and non-pharmacological treatments (e.g. cognitive training). Take a look at this excellent special issue in the Journal and think about how you can identify older adults with early-stage dementia in your practice.