Delirium: Elders Tell Their Stories and Guide Nursing Practice

Delirium is one of the most serious and prevalent cognitive disorders among hospitalized elders. Fourteen elders participated in this phenomenologic study describing the lived experience of delirium from the patient\u27s perspective. Implications for nursing practice are derived from their reality and insight

Bright light treatment of depression for older adults [ISRCTN55452501]

BACKGROUND: The incidence of insomnia and depression in the elder population is significant. It is hoped that use of light treatment for this group could provide safe, economic, and effective rapid recovery. METHODS: In this home-based trial we treated depressed elderly subjects with bright white (8,500 Lux) and dim red (<10 Lux) light for one hour a day at three different times (morning, mid-wake and evening). A placebo response washout was used for the first week. Wake treatment was conducted prior to the initiation of treatment, to explore antidepressant response and the interaction with light treatment. Urine and saliva samples were collected during a 24-hour period both before and after treatment and assayed for aMT6s and melatonin respectively to observe any change in circadian timing. Subjects wore a wrist monitor to record light exposure and wrist activity. Daily log sheets and weekly mood (GDS) and physical symptom (SAFTEE) scales were administered. Each subject was given a SCID interview and each completed a mood questionnaire (SIGH-SAD-SR) before and after treatment. Also, Hamilton Depression Rating (SIGH-SAD version) interviews were conducted by a researcher who was blind to the treatment condition. A control group of healthy, age-matched, volunteers was studied for one day to obtain baseline data for comparison of actigraphy and hormone levels. RESULTS: Eighty-one volunteers, between 60 and 79 years old, completed the study. Both treatment and placebo groups experienced mood improvement. Average GDS scores improved 5 points, the Hamilton Depression Rating Scale (HDRS) 17 scores (extracted from the self-rated SIGH-SAD-SR) improved 6 points. There were no significant treatment effects or time-by-treatment interactions. No significant adverse reactions were observed in either treatment group. The assays of urine and saliva showed no significant differences between the treatment and placebo groups. The healthy control group was active earlier and slept earlier but received less light than the depressed group at baseline. CONCLUSION: Antidepressant response to bright light treatment in this age group was not statistically superior to placebo. Both treatment and placebo groups experienced a clinically significant overall improvement of 16%

Retention of Minority Students in Higher Education Using a Student Peer Support Model

This session focuses on diversity and inclusion in the classroom using a “student peer support” model. While the example emanates from nursing education, the strategies employed have potential for application with other groups of students to enhance awareness of the minority experience in the “majority” classroom: feeling alone/different; teachers’ lack of acknowledgement of individuality and support; peers’ lack of understanding about cultural differences; and coping with insensitivity and discrimination. An introduction to a simulated intercultural experience and minority students’ stories of lived experiences will be shared

An Evidence-Based Approach for the Development of a Health and Wellness Program within a Community Center for Older Adults

PURPOSE: The purpose of this project is to develop a strategic plan for an evidence-based nurse-led model designed to provide health services and wellness care to older adults participating in a senior community center located in the Midwest. PROCEDURES: A comprehensive review of the literature has been completed to identify successful models of care and wellness programs for older adults. A needs assessment related to sustaining optimal health, developed for the project, was completed by 107 members. The results of the literature review and needs assessment informed the selection of a model designed to provide health services and wellness care to older adults. OUTCOME: A full project plan will be developed to include; 1) assessment of resources needed for implementation (human, physical, financial); 2) timeline for phased implementation; 3) an evaluation model based on desired outcome measures, with timeline; 4) proposed funding models; and 5) a nurse-led demonstration project designed to manage chronic disease and promote wellness initiatives, incorporating students from a local university nursing program. IMPACT: More than three-quarters of adults over the age of 65 suffer from at least one chronic medical condition that requires ongoing care and management. These older adults face challenges in their efforts to attain their best state of wellness. It is essential that older adults are able to manage their chronic conditions. A health services and wellness program can assist older adults in achieving their goals