Theris A. Touhy

Communicating with individuals with Alzheimer's disease: Examination of recommended strategies

Meaningful conversation with individuals in the later stages of Alzheimers disease (AD) has been considered difficult if not impossible. Limiting communication to simple concrete subjects and closed-ended questions is frequently recommended. Thirty-five 30 minute conversations with individuals with advanced AD (mean Mini-Mental State Examination [MMSE] = 10) were transcribed and the interactions examined. No significant differences in length or relevance of response by type of question was found indicating that subjects were able to respond to open-ended questions. Use of broad opening statements or questions, establishing commonalities, speaking as equals, and sharing of self-facilitated expression of feeling; recognizing themes with salience for the individual helped to maintain the discussion.

Nurturing hope and spirituality in the nursing home.

Nurturing body, mind, and spirit is part of holistic care, and yet often the primary focus of care in nursing homes is physical needs. As part of a larger study examining factors related to hope among institutionalized elders, spirituality emerged as the only significant predictor of hope. Findings supported the active presence of hope despite age and functional limitations. The significant contribution of spirituality to hope calls for attention to the provision of opportunities to support and enhance spiritual practices in the nursing home setting. Nurses in nursing homes have the opportunity to establish close relationships with residents over time, often substituting for family and friends no longer available. Because length of stay is long, more time is available to enter into meaningful spirit-sharing relationships with residents. Suggestions for interventions that nurture hope and spirituality within a holistic and caring framework are presented.

Dementia, Personhood, and Nursing: Learning from a Nursing Situation:

Appreciation of the personhood of people with dementia calls for care that looks beyond the disease to the person within. In this column the author discusses the concept of personhood for people with dementia and presents a method of teaching person-centered care developed within the theoretical framework of nursing as caring. The study of an aesthetic expression of a nursing situation, written by a nurse who cares for people with Alzheimer’s disease in a nursing home, is presented to assist nurses to learn to see beyond the disease to the person and to develop relationships that nurture personhood.

Attitudes towards caring for older people in Scotland, Sweden and the United States

AIM To explore the attitudes of nurses and nursing students in Scotland, Sweden and the US towards working with older people. METHOD This quantitative study used the 20-item Multifactorial Attitudes Questionnaire (MAQ) to elicit attitudes on ageism, resources, working environment, education and professional esteem. Researchers from each country distributed the questionnaires to nursing students and nurses, giving a convenience sample of 1,587 respondents. Data were entered on the Statistical Package for Social Sciences version 18 and merged into one large dataset. RESULTS Scottish participants had the highest (positive) and Swedish participants the lowest mean MAQ score. The Kruskal-Wallis test showed significant differences in mean scores across the countries in 18 of the 20 statements, even when controlling for age and experience. Most participants gave positive responses, but agreed that negative attitudes towards working with older people pervade among peers due to working conditions, poor career prospects and a perceived lack of professional esteem. CONCLUSION Inspirational educators, excellent clinical placements and increasing the professional esteem of those working with older people are required to promote the specialty as an attractive career option.

Caring as the Central Domain in Nursing Education

The purpose of this article is to illustrate how caring guides the study of nursing at both undergraduate and graduate levels. It is the belief of the authors that if caring is an essential concept of the discipline of nursing, then the substantive nature of this concept must be studied. It is the intent of this article to provide a clear and descriptive approach as to how to intentionally focus on the study of nursing through the lens of caring.

Attitudes of Nurses, and Student Nurses Towards Working with Older People and to Gerontological Nursing as a Career in Germany, Scotland, Slovenia, Sweden, Japan and the United States

Attitudes of Nurses, and student nurses towards working with older people and to gerontological nursing as a carrer in Germany, Scotland, Slovenia, Sweden, Japan and the United States

Expressions of Caring as Lived by Nursing Home Staff, Residents, and Families

Nursing as caring (Boykin & Schoenhofer, 1993, 2001) was utilized as the framework for design of a model of healthcare delivery in a nursing home that is intentionally grounded in caring. The article presents themes emerging from a qualitative analysis of interview data in which participants were asked what was most important when caring for a resident or family member and to share an experience that best represented caring. Suggestions are offered for creating a model of culture change in nursing homes that honors and values expressions of caring as lived by staff, families, and residents.

Touching the Spirit of Elders in Nursing Homes: Ordinary yet Extraordinary Care

Nurses in nursing homes have the opportunity to establish close, caring relationships with residents over time and often become the significant other in the lives of those whom they nurse. The opportunity to enter into spirit-sharing relationships makes it imperative to reflect on the depth and meaning of nursing practiced within a caring framework. The theory of nursing as caring (A. Boykin & S. Schoenhofer, 2001) provides the framework for understanding care that touches and supports the spirit of persons nursed. Nursing responses such as being authentically present, coming to know the person, and fostering connectedness are presented as ordinary yet extraordinary ways to touch the spirit of elders in nursing homes.