Nursing older people最新文献

Rationale and key points: Depression is the most common mental health condition in older age but often goes undetected and untreated, which can negatively affect health, well-being and quality of life. This article highlights how nurses can improve the identification of depression in older people, including by being aware of risk factors and signs and symptoms; by using proactive questioning and an individualised approach; and by encouraging older people who may have depression to discuss their mental health as part of a person-centred assessment. •Older people are highly susceptible to many of the physical and psychosocial risk factors associated with depression. •In older people, symptoms of depression can be wrongly attributed to dementia or considered a normal part of ageing. •Older people with depression may not recognise it or be reluctant to discuss it for fear of being stigmatised. •Improving the identification of depression in older people requires challenging assumptions about their mental health. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: •How this article might improve your practice when identifying an older person who may have depression. •How you could use this information to educate nursing students or colleagues about identifying an older person who may have depression.

Dementia affects cognition and therefore often results in people lacking mental capacity to make decisions about their treatment and care, resulting in decisions being made on their behalf. On such occasions, there may be differences of opinion between healthcare professionals and families, or between professionals themselves, about what constitutes the person's best interests. This is particularly the case in complex situations where the principles of biomedical ethics conflict with one another and there are no obvious 'right' or 'wrong' answers. This article outlines ethical principles in healthcare, discusses best interests decision-making and describes the so-called balance sheet approach. It also examines in more detail some ethical dilemmas commonly encountered in nursing practice when caring for people with dementia.

Health promotion enables people to increase control over their own health. It encompasses a broad spectrum of social and environmental initiatives aimed at enhancing and protecting individuals' health and quality of life ( World Health Organization 2016 ).

Background: Increasing numbers of older people admitted to acute hospitals have dementia. For nurses, providing dementia care in acute settings involves unique challenges such as ensuring staff and patient safety and managing the stress caused by insufficient resources.

Aim: To explore nurses' experiences and challenges when caring for patients with dementia in an acute general hospital setting.

Method: This study used a qualitative approach and semi-structured interviews to explore participants' experiences of caring for patients with dementia. All permanent nurses working in three acute medical wards in one NHS trust ( n =120) received an email inviting them to take part. Eight nurses volunteered to be interviewed.

Findings: Three main themes were extrapolated from the thematic analysis of interview data: attributes of dementia care; planning care effectively; and staff education and training needs. Participants emphasised the importance of person-centred care and the challenges involved in providing such care due to staff shortages, which could result in frustration, exhaustion and stress for both staff and patients.

Conclusion: Nurses in acute care settings need additional education and training to improve their knowledge and skills in relation to dementia care. The involvement of families is important for the optimal care of patients with dementia on acute hospital wards.

The term 'long lie' is often used clinically to describe a situation where an individual has had a fall and has remained on the floor. However, there is no universal definition of what constitutes a long lie or recognition of the effect it can have on physical or psychological well-being. In August 2024, the authors undertook a comprehensive literature review on the subject. A search of articles published in English from the past 45 years which refer to adults over the age of 18 years who had a fall and a long lie, identified six articles. The outcome of the review demonstrates that there is a lack of primary literature that clearly defines a long lie. Nevertheless, ambulance and community first responders are encouraged to convey to hospital patients who have been on the floor for one hour or more, directly contradicting national health agendas that promote the delivery of acute care closer to home.

Increasingly, older adults are undertaking carer roles to support other older people. They are doing this within the confusing world of healthcare consumerism, with different agencies providing different services and with variations in services across the UK. Understanding of the care work and needs of older carers is incomplete in relation to what they provide and what they believe they should seek help with. Therefore, it is important that nurses help older carers to narrate their care work and personal needs as part of an assessment of the self-care resources within the home. By doing so, nurses can better understand what support they might offer themselves and what assistance might be sought from other agencies. In this article, the author discusses the concepts of care agency and older carer narratives and describes how nurses might approach narrative enquiry by adopting the same principles used to develop person-centred care relationships.

In December 2020 the United Nations launched the Decade of Healthy Ageing initiative, a global collaboration led by the World Health Organization which spans the years 2021-2030. It was designed to change how people think, feel about and act towards age and ageing, and to ensure that communities foster the abilities of older people. However, there is still a need to ascertain how best to arrange support in a way that redefines what it means to age well. Moreover, work remains to be done on finding resource-viable interventions that could improve the resilience of older people as they age, enriching their cognitive reserve. This article discusses how social prescribing interventions may assist people to age well, and draws on a reflective case study to highlight how collaborative action via a film club might empower older people to sustain their mental well-being.

Rationale and key points: Presenting a poster at a conference is an effective way for nurses to share their work - for example, a research piece or quality improvement project - with a wider audience. It can help nurses to improve their writing and presentation skills while also benefiting colleagues and patients through the dissemination of best practice. However, if you are a novice poster author and presenter, you may find it challenging to know where to start. This article aims to guide nurses through the process of developing and presenting a conference poster, which will involve: • Consider what it is you wish to share with a wider audience and why. • Choose which conference will be a suitable forum and submit a convincing abstract. • Determine the design, structure and content of your poster. • Develop a draft, proofread it and ask a colleague or supervisor to look at it before finalising it. • Prepare yourself to discuss your poster with delegates. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when designing and presenting a conference poster. • How you could use this information to educate nursing students or your colleagues on the appropriate technique and evidence base when designing and presenting a conference poster.

Rationale and key points: Critical reflection increases nurses' competence by providing them with a method for analysing complex situations and learning from them. Reflecting critically on their practice enables nurses to recognise and question their values, beliefs and assumptions. This is essential when caring for older people because unconscious bias increases the risk of ageism and can lead to decisions that negatively affect the care provided - for example, decisions that reduce patients' autonomy and agency. This article outlines the steps nurses can take to reflect critically on their clinical practice in older people nursing, using a reflective model constructed around three key questions: 'What?', 'So what?' and 'Now what?' • Critical reflection is an essential aspect of the nurse's role that supports the continuous improvement of practice. • Critical reflection involves examining one's thoughts, feelings and actions to better understand oneself and reduce the risk of unconscious bias. • Reflecting on clinical practice can support nurses to find a balance between managing the challenges of work and maintaining their emotional well-being. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your critical reflection on clinical practice in older people nursing. • How you could use this information to educate nursing students or your colleagues on reflecting critically on clinical practice in older people nursing.

Many older people living with dementia experience multimorbidity, which has been described as the presence of two or more long-term conditions, such as congestive heart failure, type 2 diabetes or stroke. Each of these long-term conditions can cause a wide range of symptoms and almost all can involve pain. Older people may also experience sensory impairments, such as hearing and vision loss, which in those with dementia can lead to symptoms similar to the behavioural and psychological symptoms of dementia. In addition, older people with dementia can experience challenges with expressive and receptive communication. All these factors can make it challenging for nurses to effectively identify and manage symptoms related to long-term conditions in older people with dementia. This article provides an overview of multimorbidity in older people with dementia, using pain as an example of a symptom associated with multiple long-term conditions to illustrate the complexities of symptom recognition and management in this population. The authors also consider how communication issues, sensory impairment and diagnostic overshadowing can add to the complexities of symptom recognition and management, and outline some of the implications for nursing practice.