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American Journal of Nursing August 2008 Stockdell & Amella	How to Try This: The Edinburgh Feeding Evaluation in Dementia Scale: Determining How Much Help People with Dementia Need at Mealtime. The Edinburgh Feeding Evaluation in Dementia scale is an 11-item instrument developed to assess eating and feeding problems in people with late-stage dementia. Using the scale, a nurse can identify a patient's needs and build an effective care plan.
American Family Physician April 15, 2002 Ina Li	Feeding Tubes in Patients with Severe Dementia Patients with advanced dementia are among the most challenging patients to care for. Health care professionals commonly rely on feeding tubes to supply nutrition to these severely demented patients. However, various studies have not shown use of feeding tubes to be effective...
American Journal of Nursing October 2008	Wandering in Hospitalized Older Adults: Identifying Risk is the First Step in This Approach to Preventing Wandering in Patients with Dementia. People who have dementia are at risk for wandering away from the safety of the care setting and becoming lost in the community. Here are three critical elements of prevention and action.
American Journal of Nursing March 2008 Evans & Cotter	Avoiding Restraints in Patients with Dementia Understanding, prevention, and management are the keys to reducing restraint use.
American Journal of Nursing October 2008	How to Try This: Working with Families of Hospitalized Older Adults with Dementia Families provide a considerable amount of informal care and support for older adults living with dementia. And when an older adult with dementia is hospitalized, family caregivers should be seen as important sources of information and included as valuable members of the health care team.
American Family Physician February 15, 2002 Grace Brooke Huffman	Evaluating and Treating Unintentional Weight Loss in the Elderly Unintentional weight loss in the elderly patient can be difficult to evaluate. Accurate evaluation is essential, however, because this problem is associated with increased morbidity and mortality...
American Journal of Nursing January 2008 Maslow & Mezey	Recognition of Dementia in Hospitalized Older Adults Recognition of Dementia in Hospitalized Older Adults proposes several approaches that hospital nurses can use to increase recognition of dementia. This article describes the Try This approaches, how to implement them, and how to incorporate them into a hospital's current admission procedures.
American Family Physician February 15, 2006 Rayner et al.	Behavior Disorders of Dementia: Recognition and Treatment Psychosis may pose a greater challenge than cognitive decline for patients with dementia and their caregivers. Goals of treatment should include symptom reduction and preservation of quality of life.
American Journal of Nursing November 2010 Garcia & Chambers	Managing Dysphagia Through Diet Modifications Dietary modification-altering the consistency of foods and liquids-is a fundamental aspect of dysphagia management.
American Journal of Nursing July 2008 Horgas & Miller	Pain Assessment in People with Dementia The Pain Assessment in Advanced Dementia (PAINAD) scale has been designed to assess pain in this population by looking at five specific indicators.
American Journal of Nursing January 2008 Fick & Mion	How to Try This: Delirium Superimposed on Dementia Delirium is common in older adults who have dementia, but too often nurses confuse the symptoms of delirium with those of dementia and it goes unrecognized and untreated. Delirium can signal a serious underlying condition such as infection or dehydration.
American Family Physician July 15, 2004 Robertson & Montagnini	Geriatric Failure to Thrive Some elderly patients, including those who do not have acute illness or severe chronic disease, eventually undergo a process of functional decline, progressive apathy, and a loss of willingness to eat and drink that culminates in death.
American Family Physician June 1, 2002 Jeffrey L. Cummings	Guidelines for Managing Alzheimer's Disease: Part I. Assessment Family physicians play a key role in assessing and managing patients with Alzheimer's disease and in linking the families of these patients to supportive services within the community.
American Family Physician February 15, 2001 Karen S. Santacruz & Daniel Swagerty	Early Diagnosis of Dementia As more treatment options become available, it will become increasingly important to diagnose dementia early...
American Journal of Nursing April 2008 Wallace & Shelkey	Monitoring Functional Status in Hospitalized Older Adults The Katz Index of Independence in Activities of Daily Living can help nurses detect subtle changes in health and prevent functional decline.
American Journal of Nursing February 2012 Simons & Abdallah	Bedside Assessment of Enteral Tube Placement: Aligning Practice with Evidence Since the flexible Levin tube was introduced in 1921, enteral feeding has become ubiquitous. From the out-set, nurses have been responsible for confirming the correct placement of enteral feeding tubes prior to their use for alimentation or medication administration.
American Family Physician March 15, 2006 Carr et al.	Older Adult Drivers with Cognitive Impairment In patients who continue to drive, physicians should assess pertinent cognitive domains, determine the severity and etiology of the dementia, and screen for risky driving behaviors.
American Journal of Nursing November 2011	Supporting Family Caregivers: Teaching Essential Skills to Family Caregivers Nurses can use 'teachable moments' to help the transition from hospital to home care.
American Journal of Nursing October 2007 Terry Fulmer	How to Try This: Fulmer SPICES Fulmer SPICES is a framework for assessing older adults. This assessment, done regularly, can lead to the prevention and treatment of common conditions.
American Journal of Nursing October 2011 Carol Levine	Supporting Family Caregivers: The Hospital Nurse's Assessment of Family Caregiver Needs It's important to assess and address a family caregiver's needs, strengths, and limitations. Nurses have the training, skills, and opportunities to carry out these assessments.
American Family Physician January 15, 2004 Koenigsberg et al.	Facilitating Treatment Adherence with Lifestyle Changes in Diabetes Healthy eating and increased physical activity can prevent or delay diabetes and its complications. Techniques that facilitate adherence to these lifestyle changes can be adapted to primary care.
Nurse Practitioner August 2011 Davis et al.	Supportive approaches for Alzheimer Disease Alzheimer disease accounts for almost 80% of all dementia diagnoses. Currently, more than 5 million Americans suffer from this debilitating illness, with the highest prevalence in the oldest age groups.
American Journal of Nursing November 2011 Christine L. Cutugno	The 'Graying' of Trauma Care: Addressing Traumatic Injury in Older Adults Evidence-based strategies for managing trauma and its complications in this population.
Nursing October 2009 Yvonne D'Arcy	Overturning barriers to pain relief in older adults This article will describe how to lower the barriers to effective pain control in older patients and provide practical tips for helping them receive the full benefit from pharmacologic and nonpharmacologic therapies.
American Family Physician May 1, 2005 Adelman & Daly	Initial Evaluation of the Patient with Suspected Dementia It is common for older patients to present to family physicians with concerns of memory loss. With an accurate and timely diagnosis of dementia, appropriate therapies can be initiated to reduce further cognitive decline.
American Journal of Nursing April 2006 Rader et al.	The Bathing Of Older Adults with Dementia Inexpensive, practical, and evidence-based alternatives to force bathing patients are advocated and discussed.
American Journal of Nursing December 2011 Mary K. Walton	Supporting Family Caregivers: Communicating with Family Caregivers A transformation is under way in acute care, at least in the United States, from provider-centered care to patient- and family-centered care.
American Family Physician March 1, 2003 Ondria C. Gleason	Delirium Delirium is characterized by an acute change in cognition and a disturbance of consciousness, usually resulting from an underlying medical condition or from medication or drug withdrawal. The associated morbidity and mortality make diagnosis of this condition extremely important.
American Family Physician October 1, 2000 Richard J. Ackermann	End-of-life Care Withholding or withdrawing life-sustaining therapies is ethical and medically appropriate in some circumstances. This article summarizes the American Medical Association's Education for Physicians on End-of-life Care curriculum module on withholding or withdrawing therapy...
American Family Physician July 1, 2005 Shobha S. Rao	Prevention of Falls in Older Patients Physicians caring for older patients should ask about any falls that have occurred in the past year. Assessment should include evaluating the circumstances of the fall and a complete history and physical examination, looking for potential risk factors.
American Journal of Nursing September 2011 Schmid et al.	Care of the Suicidal Pediatric Patient in the ED: A Case Study At Childrens Hospital Boston, an algorithm-the Risk of Suicidality Clinical Practice Algorithm has been developed to ensure evidence-based care supported by best practice guidelines.
American Journal of Nursing August 2011 Craft & Prahlow	From Fecal Impaction to Colon Perforation The authors present the case of an elderly, nonverbal nursing home resident with dementia who developed fecal impaction, despite interventions such as enema.
American Family Physician September 15, 2004 Thibault & Steiner	Efficient Identification of Adults with Depression and Dementia Family physicians must decide how to screen for depression or dementia and which patients to screen. Mental health questionnaires can be helpful, but are not without flaws.
Nursing April 2012 Elliott et al.	Managing alcohol withdrawal in hospitalized patients A focused nursing assessment is critical in identifying the potential for alcohol withdrawal symptoms in all hospitalized patients. This article discusses how to assess patients at risk and how to use these assessment findings as a basis for nursing interventions.
American Family Physician April 1, 2006 Neef & Walling	Dementia with Lewy Bodies: An Emerging Disease Dementia with Lewy bodies appears to be the second most common form of dementia, accounting for about one in five cases. The condition is characterized by dementia accompanied by delirium, visual hallucinations, and parkinsonism.
American Journal of Nursing April 2010 Mary Curry Narayan	Culture's Effects on Pain Assessment and Management When patients belong to a culture or speak a language that's different from that of their health care provider, the provider faces additional challenges in successfully assessing and managing the patients' pain.
Nursing August 2010 Bartley & Shiflett	Handle older trauma patients with care Your comprehensive understanding of how age-related changes can affect outcomes during and after trauma will help your patients recover to the fullest extent possible.
American Journal of Nursing July 2010 Ruppar & Conn	Interventions to Promote Physical Activity in Chronically Ill Adults The health benefits of physical activity in chronic illness are well documented.
American Journal of Nursing October 2005 Charlotte Thomas-Hawkins	Self-Management of Chronic Kidney Disease Effective management of this disease requires the patient to be the principal illness manager and this skill requires the nurses guidance and support.
American Family Physician December 15, 2000 Susan Mockus Parks & Karen D. Novielli	A Practical Guide to Caring for Caregivers Patients who provide care to family members or friends with dementia are likely to be in a family physician's practice. The caregiver role can be stressful, and identifying these patients can give the family physician opportunities to help patients cope with the challenges of the role...
Nursing Management April 2012 Gloria Kersey-Matusiak	Culturally competent care: Are we there yet? What exactly is culturally competent care, and how can you use it to lessen healthcare disparities among your patients?
American Family Physician June 15, 2006 Prater & Zylstra	Medical Care of Adults with Mental Retardation Primary medical care of persons with mental retardation should involve continuity of care, maintenance of comprehensive treatment documentation, routine periodic health screening, and an understanding of the unique medical and behavioral disorders common to this population.
Nursing September 2008 Denise L. Lyons et al.	Double Trouble: When Delirium Complicates Dementia Learn to protect a patient with dementia from the disabling effects of delirium.
American Family Physician October 1, 2006 Kavan et al.	A Practical Guide to Crisis Management Physicians often are required to assist patients in crisis. An estimated 4% of visits to primary care physicians involve psychiatric or social crises.
Nursing March 2010 Peg Gray-Vickrey	Gathering pearls of knowledge for assessing older adults If you attended nursing school more than 10 years ago, you may have received limited education about gerontological nursing. But as baby boomers age, this is becoming an increasingly important area of nursing practice.
American Journal of Nursing November 2007 Ann Hendrich	How to Try This: Predicting Patient Falls Assess a hospitalized patients risk of falling using this screening tool.
American Journal of Nursing September 2009 Judith K. Schwarz	Stopping Eating and Drinking The author describes stopping eating and drinking, as well as other clinical practices associated with hastening dying. Should this practice be distinguished from suicide; and what are the ethical and legal implications for nurses.
American Family Physician October 1, 2006 Susan Louisa Montauk	The Homeless in America: Adapting Your Practice In 2004, the National Guidelines Clearinghouse placed eight guidelines from the National Health Care for the Homeless Council on its Web site. Seven of the guidelines are on specific disease processes and one is on general care.
Nursing September 2011 Yantis & Velander	Untangling enteral nutrition guidelines This article discusses the latest EN practice recommendations issued in 2009, with an emphasis on specific nursing applications and patient safety.
American Journal of Nursing October 2007 Levensky et al.	Motivational Interviewing: An Evidence-Based Approach to Counseling Helps Patients Follow Treatment Recommendations This article will help nurses learn how to use motivational interviewing to encourage patients to adhere to treatment recommendations.