Copyright (c) 2012 All rights reserved. http://works.bepress.com/marianne_smith Recent documents in Marianne Smith en-us Sun, 25 Nov 2012 13:57:38 PST 3600 http://works.bepress.com/marianne_smith/50 http://works.bepress.com/marianne_smith/50 Tue, 08 Nov 2011 10:37:18 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/49 http://works.bepress.com/marianne_smith/49 Tue, 08 Nov 2011 10:37:11 PST Marianne Smith http://works.bepress.com/marianne_smith/48 http://works.bepress.com/marianne_smith/48 Tue, 08 Nov 2011 10:37:06 PST Although dedicated geropsychiatric units have been available for many years, little information is available about them as a group. This article describes a survey that was developed to learn what type of resources, policies, or procedures geropsychiatric inpatient units employed to promote best nursing care practices. Physical changes to the unit and enhanced staff training were components of the current units and were consistently identified as needing enhancement to move to the next level of excellence. An unanticipated outcome was survey respondents' interest in becoming a part of a network of individuals who provide inpatient geropsychiatric care.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/47 http://works.bepress.com/marianne_smith/47 Tue, 08 Nov 2011 10:37:00 PST The importance of redesigning nursing homes to better emulate living in one's own home has driven regulation reform for decades. The early focus of addressing residents' rights in the Nursing Home Reform Act has slowly expanded to a broader vision of creating "a culture of aging that is life affirming, satisfying, humane and meaningful." Commonly called "culture change," the movement to improve quality of life among older adults in nursing facilities and LTC settings has gained considerable momentum. The primary advocacy group, the Pioneer Network, emphasizes values such as knowing the person, putting the person before the task, emphasizing self-determination, promoting growth and development, and using the environment to its best potential.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/46 http://works.bepress.com/marianne_smith/46 Tue, 08 Nov 2011 10:36:55 PST Older adults who exhibit behavioral symptoms, particularly aggression, are increasingly being admitted from long-term care settings to psychiatric units for evaluation and treatment. Posthospitalization "success" is often limited, suggesting that improved understanding and communication between nurses who work in nursing homes and those who work in hospital inpatient units may be needed. With use of a video about older adults and aggression as a basis for education, discussion, and interaction, geriatric/long-term care and psychiatric nurses participated in a day-long program. The conference was designed to bring the two groups together to focus on common problems and solutions, sharing information, and networking. Quantitative evaluation, including 15 items that rated the relevance, usefulness, and overall quality of the program and teaching approaches, and qualitative evaluation in the form of narrative comments about the program's most and least useful aspects, support the value of the approach. n

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/45 http://works.bepress.com/marianne_smith/45 Tue, 08 Nov 2011 10:36:50 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/44 http://works.bepress.com/marianne_smith/44 Tue, 08 Nov 2011 10:36:45 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/43 http://works.bepress.com/marianne_smith/43 Tue, 08 Nov 2011 10:36:40 PST This paper describes an elderly outreach program (EOP) designed to identify and provide mental health services to the rural elderly. The project integrates a variety of health, mental health, and human service agencies in the planning and delivery of services. Five referral sources are identified and described as well as the assessment, treatment, and referral process. Outcomes are discussed in terms of: characteristics of persons served, ability of the project to identify and deliver mental health services, treatment effectiveness, and cost effectiveness of the project. The EOP seems to have prevented an increase in need for mental health care among Iowans that might have occurred in the program's absence.

]]> Kathleen Buckwalter et al. http://works.bepress.com/marianne_smith/42 http://works.bepress.com/marianne_smith/42 Tue, 08 Nov 2011 10:36:35 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/41 http://works.bepress.com/marianne_smith/41 Tue, 08 Nov 2011 10:36:29 PST Seemingly simple adjustments in care routines and approaches can make a significant difference in the experiences of people with dementia. This article provides an overview of cognitive impairment in older adults and suggests interventions that can help providers understand the "behavioral symptoms" of dementia, which are often considered a way of communicating unmet needs. By focusing on the person rather than on the disease, nurses promote comfort and functional autonomy in older adults whose cognitive impairments have progressed and yet who are very much alive and deserving of respectful, dignified care.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/40 http://works.bepress.com/marianne_smith/40 Tue, 08 Nov 2011 10:36:24 PST Over the last two decades, increasing attention has been paid to the nature of behavioral symptoms in dementia. Early notions that all behaviors were an inevitable component of cognitive impairment have all but disappeared in the face of evidence that diverse personal, social, and environmental factors regularly act as antecedents to behavioral and psychologic symptoms of dementia (BPSD). The quality of care provided to persons with dementia has been advanced through nursing care conceptual models that explain antecedents to BPSD and, in turn, offer specific interventions to promote comfort and optimal function.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/39 http://works.bepress.com/marianne_smith/39 Tue, 08 Nov 2011 10:36:18 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/38 http://works.bepress.com/marianne_smith/38 Tue, 08 Nov 2011 10:36:13 PST Creative, collaborative approaches between sub-specialties in nursing are needed to improve the quality of care and, hence, the quality of life for mentally ill and behaviorally impaired older adults living in long-term care (LTC) facilities. Results of a consultation survey collected as part of a larger geriatric mental health training project, and described in this article, support the position that consultee-centered geropsychiatric nursing consultation services are an important adjunct to training. However, this indirect approach to service enhancement may not be well understood and, as a result, not well utilized by LTC nurses. Methods to facilitate understanding and utilization of "indirect" mental health assistance to LTC residents and staff are explored within the context of building productive liaisons among nurses.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/37 http://works.bepress.com/marianne_smith/37 Tue, 08 Nov 2011 10:36:07 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/36 http://works.bepress.com/marianne_smith/36 Tue, 08 Nov 2011 10:36:02 PST TOPIC: Pain assessment is a particular challenge among individuals with advanced dementia who lack the ability to formulate and express their experience of discomfort. PURPOSE: Awareness of pain scales and methods specifically designed for use with nonverbal individuals with dementia is critical to expanded use and testing in clinical settings. SOURCES: Computerized literature searches using four databases revealed the five observational scales and two caregiver reports methods reviewed. CONCLUSIONS: A small number of valid, reliable, and sensitive scales are available for use by nurses and allied health personnel. Each has strengths and limitations and all would benefit from additional testing.

]]> Marianne Smith http://works.bepress.com/marianne_smith/35 http://works.bepress.com/marianne_smith/35 Tue, 08 Nov 2011 10:35:56 PST John S. Levin et al. http://works.bepress.com/marianne_smith/34 http://works.bepress.com/marianne_smith/34 Tue, 08 Nov 2011 10:35:53 PST Kathleen Buckwalter et al. http://works.bepress.com/marianne_smith/33 http://works.bepress.com/marianne_smith/33 Tue, 08 Nov 2011 10:35:49 PST Although mental illness among elderly living in nursing homes is a substantial and growing concern, the behavioral problems associated with mental illness or threats to mental health are not well understood, tolerated, or effectively managed by nursing home staff. As a result, resident care and quality of life, and staff morale often suffer. The need for geriatric mental health training in long-term care settings has become increasingly apparent. Psychiatric/mental health nurses are in an advantageous position to address this current need and future challenge through the development, implementation, and evaluation of geriatric mental health education and training programs in long-term care settings. This article describes one such innovative training effort, designed to improve the quality of psychosocial care provided by nursing personnel in rural long-term care settings, and highlights evaluation outcomes related to participant satisfaction, staff knowledge, and attitudes.

]]> Marianne Smith et al. http://works.bepress.com/marianne_smith/32 http://works.bepress.com/marianne_smith/32 Tue, 08 Nov 2011 10:35:44 PST Marianne Smith et al. http://works.bepress.com/marianne_smith/31 http://works.bepress.com/marianne_smith/31 Tue, 08 Nov 2011 10:35:40 PST Marianne Smith et al.