Lisa Skemp Kelley

Issues in conducting research in nursing homes

Anticipation of increased numbers of older persons throughout the coming decades who will require care and assistance with chronic illnesses and functional deficits has correspondingly increased awareness of the need for nursing research to support best geriatric nursing practices. Although badly needed, research in nursing homes presents challenges. This article discusses issues and challenges of ethically acceptable and rigorous research in nursing homes that are related to the dependency and institutionalization of older persons and to setting, staff, and resident characteristics. Strategies for easing the challenges of nursing research in nursing homes are offered.

Cognitive-Behavioral Techniques to Reduce Pain - a Validation-Study

The purpose of this study was to identify and validate specific activities considered important in the implementation of three non-pharmacologic pain management interventions--relaxation, distraction and guided imagery. Using a two-round Delphi survey, nurses selected for their expertise in pain management were asked to validate definitions and activities considered important in the implementation of each of these strategies. Data were analyzed using a modification of Fehrings diagnostic content validity method. From this process, a list of activities for each intervention evolved that has implications for nursing research, practice and education.

Who's the boss? Family/staff partnership in care of persons with dementia

This article provides an overview of family involvement in care intervention and its implementation with African American and Caucasian family members of persons with dementia in nursing home settings.

IATROGENESIS IN THE ELDERLY: Factors of Immobility

Mobility of elderly patients is a consequence of the interaction between factors including biological health, sensory-perceptual capacity, motor skills, cognitive capacity, and ego-strength; and environmental resources including physical and architectural features, medical regimens, institutional policies, resident and staff characteristics, and social support availability. Impaired mobility, whether self- or other-imposed, places the elderly at risk for a multitude of negative physiological and psychological consequences that can affect health, well-being, and quality of life. Understanding the basic mechanisms underlying the physiological and psychological consequences of immobility, the relative time-frame in which they can develop, and the concomitant changes associated with aging provides the basis for interventions aimed at preventing or minimizing them. A multitude of factors that influence the elderlys state of mobility are within nursings realm of practice. Although elderly patients may present a special challenge, the negative consequences of immobility can be avoided, to a significant extent, with astute and vigilant nursing management.

Staff stress on an Alzheimer's unit

Nurses working with the elderly encounter many complex and potentially stressful care situations. Nowhere is this more true than for nursing home staff who work in highly demanding, labor- and client-intensive jobs. A number of factors contribute to the high levels of stress found among nurses who work with the elderly, including continual exposure to physical and emotional pathology and death, and conflict with families, co-workers, supervisors, and representatives from other departments or professions (Goldin, 1985; Klus, 1980). When the stress level in a long-term care facility becomes overwhelming, role conflict, ambiguity, poor self-esteem, and burnout may ensue (Goldin, 1985; Heine, 1986; Klus, 1980; Morrow-Winn, 1985). The process of burnout is characterized by a progressive loss of idealism, energy, and purpose that eventually leads to emotional overextension and exhaustion (Price, 1984).

Iatrogenesis in the elderly. Impaired skin integrity

Risk factors that contribute to pressure ulcer formation include immobility and inactivity, age, malnutrition, fecal and urinary incontinence, and a decreased level of consciousness. Gerontological nurses should collaborate with other health disciplines (eg, the physician, physical therapist, and dietitian) to plan and provide preventive treatment measures for the elderly person with potential for impaired skin integrity: pressure ulcers. Gerontological nurses must continue the development and refinement of tools with which to predict the degree of risk for impaired skin integrity, as well as use a consistent method of grading pressure ulcers.

Cross-Cultural Health Education: Materials on the World Wide Web

Language differences between health providers and consumers create a central barrier to the delivery of health education. This article presents the results of an analysis of more than 75 bi/multilingual health sites available on the Internet. The review criteria and a summary of the key features of the best sites are presented. Limitations common to most sites are identified. Recommendations and caveats in the use of bilingual health information sites are introduced.

Elder Care Exchanges in a Caribbean Village

Caregiver gender research often translates into caregiver accounts of the care they provide for an elder parent or spouse, limiting an understanding of other communitymembers’involvement and the actual gendered elder care activities performed and caregiver benefits received. This article describes women’s and men’s actual involvement in elder care. These findings are part of a fourphase ethnographic community study that includes in-depth network analysis of elder households. One-hundred and forty-three informal adult caregivers assisted 15 elders in obtaining the things they needed to live, providing 244 care activities. One-hundred and three women provided 194 care activities, and 40 men performed 50 care activities. In exchange, the frail elders gave the women caregivers 132 benefits and the men 54 benefits. Women and men differed in the amount and type of care involvement, as well as their motivational mechanisms for involvement in elder care.