Sandra F. Simmons

Translating clinical research into practice: A randomized controlled trial of exercise and incontinence care with nursing home residents

OBJECTIVES: To examine clinical outcomes and describe the staffing requirements of an incontinence and exercise intervention.

Functional Incidental Training, Mobility Performance, and Incontinence Care with Nursing Home Residents

OBJECTIVE: To determine if an exercise intervention, Functional Incidental Training (FIT), results in improvements in mobility endurance and physical activity when compared with prompted voiding (PV) among cognitively and mobility impaired nursing home residents.

An Intervention to Increase Fluid Intake in Nursing Home Residents: Prompting and Preference Compliance

OBJECTIVE: To evaluate a three‐phase, behavioral intervention to improve fluid intake in nursing home (NH) residents.

Nutritional intake monitoring for nursing home residents: a comparison of staff documentation, direct observation, and photography methods.

BACKGROUND: The current approach to assessing nutritional intake requires nursing home (NH) staff to document total percentage of food and fluid consumed at each meal. Because NH staff tend to significantly overestimate total food intake, methods need to be developed to improve the accuracy of food intake measurement.

Prevention of Unintentional Weight Loss in Nursing Home Residents: A Controlled Trial of Feeding Assistance

OBJECTIVES: To determine the effects of a feeding assistance intervention on food and fluid intake and body weight.

The Nighttime Environment, Incontinence Care, and Sleep Disruption in Nursing Homes

Objective: To evaluate the association between noise, light, nursing care practices, and nighttime awakenings in incontinent nursing home residents.

Accuracy of Nursing Home Medical Record Information about Care‐Process Delivery: Implications for Staff Management and Improvement

Arguments have been made that the culture of nursing homes (NHs) must change to improve the quality of care, and two initiatives have been designed to accomplish this goal. One initiative is to provide resident outcome information (quality indicators) to NH management and consumers via public reporting systems. This initiative is based on the assumptions that resident outcomes are related to care processes implemented by NH staff, the NH industry will respond to market forces, and there are management systems in place within NHs to change the behavior of direct care staff if outcomes are poor. A separate staffing initiative argues that NH care will not improve until there are resources available to increase the number of direct care staff and improve staff training. This initiative also assumes that systems are in place to manage staff resources. Unfortunately, these initiatives may have limited efficacy because information useful for managing the behavior of direct care providers is unavailable within NHs. Medical record documentation about daily care‐process implementation may be so erroneous that even the best‐intentioned efforts to improve the care received by residents will not be successful.

Does Physical Activity Improve Sleep in Impaired Nursing Home Residents

OBJECTIVES: To determine if two physical activity programs of varying intensity would result in improved sleep among incontinent and physically restrained nursing home residents.

Feeding assistance needs of long-stay nursing home residents and staff time to provide care.

OBJECTIVES: To describe the staff time requirements to provide feeding assistance to nursing home residents who require three different types of assistance to improve oral food and fluid intake (social stimulation, verbal cuing, or both; physical guidance; or full physical assistance) and to determine whether physically dependent residents require more staff time, as defined in the national Resource Utilization Group System (RUGS) used for reimbursement.

Selection Bias in Samples of Older Twins? A Comparison between Octogenarian Twins and Singletons in Sweden

Twin studies are a powerful approach for estimating genetic and environmental influences in later life, but the usual requirement that both twins are alive may introduce a selection bias in gerontological studies relative to representative samples of nontwins. In the present study, samples of older twins and nontwins in Sweden were compared across the domains of vitality, well-being, physical and cognitive functioning, and health utilization to evaluate possible selection bias. One member of each twin dyad in the OCTO-Twin Study of intact twin pairs older than age 80 was randomly selected (N = 128) and compared with a population-based sample of nontwins (N = 324) from the OCTO Study. Multiple regressions adjusting for differences in demographic variables showed significant effects for twin status in only 3 of 20 comparisons. The results suggest that twin pairs surviving into very late life are similar to a representative sample of nontwins of the same age in health status and biobehavioral functioning. These findings support the generalizability of twin studies for understanding genetic and environmental influences on aging, health, and behavior.