Beth E. Barba

The positive influence of animals: animal-assisted therapy in acute care.

Animal-assisted therapy is a therapeutic nursing intervention that brings animals together with persons with physical and/or emotional needs as a way of meeting those needs. It is based on the growing knowledge of benefits that animals provide to the sick, elderly, and isolated. A model for a responsible and outcome-oriented program in animal-assisted therapy in acute care settings is described in this article. Special areas include: types of therapy, specific treatment goals, patient and animal suitability, environmental considerations, and evaluation methods.

A Critical Review of Research on the Human/Companion Animal Relationship: 1988 to 1993

Fifty-two research reports from the human/companion animal relationship literature published from 1988 to 1993 were reviewed using a shortened farm of the Selby Research, Assessment Form II (RAF) Descriptive data were analyzed for characteristics such as attributes of authors, grant funding, purposes, quality of literature reviews and conceptual frameworks, settings and sampling, research designs, and implications for future research. Qualitative data describing results of studies were summarized. Over half of the studies were published in Anthrozoos and were not grant funded. These were primarily nonexperimental studies using nonprobability, nongeneralizable samples. Social support was the most frequently cited framework. Understudied populations were rural groups, the middle aged, adolescents, and institutionalized elders. Few errors were committed in describing instruments or reporting analyses of data.

Thriving: A Life Span Theory

There is a need for aging theories to become holistic and multidisciplinary with a life span focus. A theory is the construction of explicit explanations in accounting for empirical findings. A good gerontological theory integrates knowledge, tells how and why phenomena are related, leads to prediction, and provides process and understanding. In addition, a good theory must be holistic and take into account all that impacts on a person throughout a lifetime of aging. Based on these criteria, the authors created the Theory of Thriving, with a holistic life span perspective for studying people in their environments as they age. This article proposes a theory for studying people over time in a holistic, encompassing manner.

Assessing medication knowledge and practices of older adults

An assessment instrument for home health nurses to use in assessing medication knowledge and practices of older adults was developed and tested on a convenience sample of 20 adults 65 and older admitted to a local home health agency. The tool was found usable by nurses, understood by patients, and had adequate test-retest reliability. The results emphasized the need for thorough medication assessments of all home health patients and provided a tool that home care nurses can use.

Characteristics of nursing homes adopting environmental transformations

During the past few years, many nursing homes in North Carolina have formulated plans to transform or enhance their environments to make the facilities more desirable places to live and work. The purpose of this study was to compare characteristics of facilities adopting one specific model for environmental transformation. The Eden Alternative; with those adopting other environmental transformations or making no changes. Surveys were mailed to administrators of all (n = 378) certified nursing facilities in NC. A total of 167 surveys were returned, for a return rate of 44%. Of these, almost three fourths were planning or implementing some sort of environmental transformation. Thirty-seven facilities (22%) indicated they were currently adopting the Eden Alternative, and 47 (28%) were planning to adopt it. Twenty-six facilities (16%) reported they were currently adopting an environmental transformation other than the Eden Alternative, and another 9 (5%) were planning to adopt another environmental transformation. The facilities adopting or planning environmental transformation other than the Eden Alternative reported adopting (or planning to adopt) various components of the Eden Alternative. Forty-six facilities (28%) indicated they had no plans for environmental transformation. Facilities making environmental transformations were found to be similar to those making no changes on most variables examined, supporting the conclusion that environmental transformation is feasible for facilities with a wide range of characteristics.

Sensory and Nurturing Nonpharmacological Interventions for Behavioral and Psychological Symptoms of Dementia

This article is part three of a four-part series addressing the use of nonpharmacological interventions in place of or in conjunction with psychotropic medications in older adults with cognitive impairment. Acquiring a better understanding of the mechanics for how each intervention works makes selection of an intervention easier at the time it is needed. Selection of the appropriate nonpharmacological intervention is based on person-centered care and how to adapt and implement it for each individual. Selection also depends on target behavior, behavior triggers, and the physical and cognitive functioning of the individual with the behavioral and psychological symptoms of dementia. Nonpharmacological interventions can be implemented by all staff members, not just recreational and activity personnel. The Centers for Medicare & Medicaid Services initiative would like to see all staff involved with these interventions, which can be implemented on the spot, as they are needed, to prevent, reduce, or stop a particular behavior. The current article will describe sensory and nurturing interventions, present the evidence supporting their use, and provide information on effective implementation.

The role of therapeutic use of self in the application of nonpharmacological interventions.

The Centers for Medicare and Medicaid Services launched a new initiative aimed at improving behavioral health and safeguarding older adults residing in nursing homes from unnecessary antipsychotic drug use. This article is part two of a four-part series on how caregivers working with older adults can implement nonpharmacological interventions. Many different types of nonpharmacological interventions exist, including staff techniques, communication skills, the identification of basic and medical needs, and actual activities, which may be performed alone, one-on-one, or in small groups. To implement nonpharmacological interventions, a trusting relationship must be established. What is done, what is not done, and how one behaves can all precipitate or prevent agitation, anxiety, depression, and apathy in older adults. This article will address the trusting relationship concept that must be actualized for nonpharmacological interventions to be successful.

Nonpharmacological interventions in long-term care: feasibility and recent trends.

Numerous studies have found excessive or in appropriate use of antipsychotic drugs in nursing home patients with cognitive impairment or perceived behavioral issues. Inappropriately medicating this vulnerable population can lead to several negative outcomes, including failure to have needs met, injury, illness, and even death. In response to recent literature and government reports highlighting this issue, in 2012, the Centers for Medicare and Medicaid Services (CMS) launched an initiative called the National Partnership to Improve Dementia Care. This article discusses the CMS initiative, as well as the feasibility and recent trends in the use of nonpharmacological interventions that could be implemented when working with patients with cognitive impairment and behavioral and psychological symptoms associated with dementia.

Older Adults: What Every Paediatric Nurse Should Know

Older adults have always been important parts of childrens lives, playing a variety of roles including grandparent, caregiver, friend, and neighbour. Grandparents also play a variety of roles in families. Often a childs first encounter with serious illness or death involves a grandparent or other older adult. Grandparents are also increasingly serving as primary caregivers for children. Paediatric nurses have long recognised their role in helping children cope with grief and loss associated with illness or death of a grandparent. Paediatric nurses need to be able to provide appropriate interventions and teaching when older adults are primary caregivers or assisting parents in the day-to-day care of the child. They also need to have sufficient knowledge about older adults to help parents and children understand the normal changes they will see in their aging loved ones, and to help parents effectively incorporate grandparents and older adults into childrens lives.