Caring for older adults with bipolar disorder

Bipolar disorder is a recurrent, chronic mental illness that has a profound impact on the lives of patients and their families and may require extensive use of mental health services. Although bipolar disorder is often considered an illness of young people, the disorder is being recognized as more common in older adults than previously thought. Much more research needs to be done to understand the impact of aging on the course and treatment of bipolar disorder. Evidence-based interventions for treatment of this disorder in older adults must be developed. Mental health nurses can play a key role in enhancing medication adherence, implementing structured psychosocial interventions, and carrying out research to enhance diagnosis and treatment of older adults with bipolar disorder.     

Functional benefit of power training for older adults

Aging leads to significant losses in muscle mass, strength, and the ability to independently perform activities of daily living (ADL). Typically, standard resistance training (RT) has been used to reduce these losses in function by maintaining or even increasing muscle strength in older adults. Increasing strength does not necessarily, however, result in an increase in the ability to perform ADL. There is now research suggesting that muscle power is more closely associated with the performance of ADL than muscle strength is, so training for muscle power might lead to more beneficial results in functional performance. This review of studies investigating the effect of training on ADL performance in older adults indicated that standard RT is effective in increasing strength in older adults, but power training that contains high-velocity contractions might be a more optimal means of training older adults when the emphasis is on increasing the performance of ADL.     

Schizophrenia in older adults

Although the number of people older than 55 with schizophrenia is expected to double during the next 20 years, the research data on older adults with schizophrenia are limited. This appears to be because until the middle of the 20th century, it was assumed that mental illness in older adults was a part of the aging process and because older adults are often excluded from research investigations. Nursing research is needed to explore how people with schizophrenia learn to manage their problems as they age, as well as how those who are first diagnosed with schizophrenia in later life adapt to their illness. Mental health nurses need to be cautious in assigning premature labels to older adults with mental illness that may lead to unsubstantiated assumptions about levels of disability. Instead, nurses should realize individual potential regarding undiscovered strengths and should attempt to create interventions that recognize and foster personal development for older adults with schizophrenia.     

Computer acceptance of older adults

Even though computers play a massive role in everyday life of modern societies, older adults, and especially older women, are less likely to use a computer, and they perform fewer activities on it than younger adults. To get a better understanding of the factors affecting older adults' intention towards and usage of computers, the Unified Theory of Acceptance and Usage of Technology (UTAUT) was applied as part of a more extensive study with 52 users and non-users of computers, ranging in age from 50 to 90 years. The model covers various aspects of computer usage in old age via four key constructs, namely performance expectancy, effort expectancy, social influences, and facilitating conditions, as well as the variables gender, age, experience, and voluntariness it. Interestingly, next to performance expectancy, facilitating conditions showed the strongest correlation with use as well as with intention. Effort expectancy showed no significant correlation with the intention of older adults to use a computer.     

Music as a healing art for older adults

There is increasing evidence of the importance of regular mental and physical exercise to maximize overall health and functioning in older adults. However, many individuals find that reduced strength or disabilities prevent them from participating in the kinds of exercise they enjoyed when they were younger. Music can provide the important benefits of both mental and physical stimulation to even frail older adults. Whether using Conductorcise for aerobic exercise, enjoying the communal experience of singing in a choir, or quietly reflecting on a music recording, music can serve as a healing art for older adults.     

An integrated dementia intervention for Korean older adults

Called dotage in Korea, dementia is primarily characterized by cognitive impairments. Secondary manifestations include mental-emotional problems, including depression. This study was designed to examine the effects of an integrated dementia intervention for Korean older adults. The intervention is composed of cognitive stimulation training, exercise, music, art, and horticultural therapy. Participants included 38 older adults with mild dementia. Twenty were assigned to the experimental group and 18 to the control group. Participants in the experimental group attended 18 program sessions. Significant differences were found postintervention between the two groups in measures of cognitive function, depression levels, and mental-emotional health. The findings indicate that this integrated dementia intervention can be applied to help older adults with mild dementia.     

Application and analysis of the affinities diagram on the examination of usability problems among older adults

Older adults have been facing usability problems every day, and with the increasing of life expectation those issues will be more and more frequent. The study of this group capacities and limitations could help designers to project systems more usable to everyone.     

Chronic pain in older adults

Despite the sophisticated pharmaceutical agents and technologies available today, many people, including older adults, continue to experience chronic pain. Inadequately treated chronic pain can seriously affect one's quality of life. Health care providers are only beginning to understand the structural and functional changes that occur in older adults with chronic pain, but recent research suggests that nurses and other health professionals need to become aware of the unique needs of older adults who live with chronic pain. When health professionals lack specific knowledge of pain management in older adults, patients may suffer needlessly.     

Union-management solutions for preventing workplace injury of older workers

As the US workforce continues to age, organized labor and management will have to work creatively to redesign jobs, workflow, and work pace to accommodate older workers. Union-management cooperation in developing safety strategies have been largely unsuccessful because of mutual distrust, animosity left over from contract negotiations and administration, the absence of strong labor legislation that promotes shared governance, injury concealment, and world-wide competitive pressures to reduce labor costs at the expense of worker safety. If workplace injury prevention that focuses on cost-effective and efficient workplace modifications for older as well as for all workers is to become reality, then employers and their unions will need to develop solutions to forge new, more expansive approaches to accommodation.     

Health literacy in older adults

Health literacy is a critical goal for nurses to address. Consider the patient who stated: They told me I was taking double the medication I was supposed to. I had two bottles, and I was taking one from each bottle, but it turned out they were the same medication. But since I didnt know how to read. I didn't know. (University of Virginia Health Systems, 2003). Many older adults struggle daily to manage their health care problems; compounding these dificulties with low literacy skills can be devastating. They need our help.     

Understanding hoarding in older adults

Compulsive hoarding is a debilitating disorder that is only recently becoming understood. Hoarding has been studied primarily in the general population, with only a few researchers focusing on hoarding in older adults, even though the prevalence and severity of the disorder appears to increase with aging. Hoarding seriously affects the quality of one's life and can also cause safety and health problems for individuals and the community. Established treatments for hoarding are relatively new and often need to be extended over a long period of time. Nurses can play an important role in helping identify the problem of hoarding in older adults, determining the types of safety and health hazards that need to be addressed, and contacting the appropriate community agencies.     

Operationalizing environmental indicators for physical activity in older adults

This qualitative study describes environmental supports and barriers to physical activity in an older adult sample drawn from low- and high-walkable neighborhoods. Thirty-seven individuals age 55 and over were recruited and answered open-ended survey questions, with a subsample invited back to partake in a semistructured interview. Content analysis identified categories and themes linking perceptions of neighborhood-environment characteristics to activity. Emerging categories and themes did not differ across neighborhood walkability, so results are presented for both groups combined. Infrastructure was the most common category identified to encourage activity, specifically, well-maintained sidewalks, bike paths or lanes, and traffic control. Other categories of land use, landscape, and aesthetics were reported. Poorly maintained or missing sidewalks, crosswalks, bike paths or lanes, and traffic safety were categories that discouraged activity. In conclusion, the information obtained is helpful in solidifying which environmental characteristics are important to measure as they relate to activity behavior in an older adult population.     

Reducing attrition in physical activity programs for older adults

This study investigated attrition in a 6-month physical activity intervention for older adults. The program was based on the social-cognitive theory incorporating self-efficacy factors. Two hundred forty-eight insufficiently active 65- to 74-year-olds were recruited from the Australian federal electoral roll. The intervention comprised walking and strength and flexibility exercises and was conducted in 30 local neighborhoods where the participants resided. Characteristics of individuals lost to attrition (n = 86, 35%) were compared with those of program completers (n = 162, 65%). Logistic-regression analysis showed that those lost to attrition came from areas of lower socioeconomic status, were overweight and less physically active, and had lower walking self-efficacy scores and higher loneliness scores. The results suggest that early assessment of these characteristics should be undertaken to identify individuals at risk of attrition, to improve retention, and to avoid potential bias.     

Developing programs for older adults in a faith community

I have worked in all areas of nursing, from staff and head nurse positions to faculty and administrative positions, but my work as a parish nurse, particularly with our community of older adults, is one of the most challenging and rewarding areas of nursing practice I have ever experienced. Recently, one of our independent older adult parishioners, Marge, suddenly had a marked decrease in her ability to function, which was precipitated by two trips to the hospital and surgery. She went from living independently to living in a skilled care unit, no longer able to walk or perform activities of daily living without assistance. I had known Marge for only 2 years. When she became ill, I visited her weekly during the last 4 months of her life, as she had no family in the area. During my visit one evening as I helped Marge get ready for bed, she left me with a very poignant memory. After sharing some hair-raising stories about her care at this facility, she said, "Georgine, you're my best friend. You're the only one I can tell these things to and I know you understand."     

Representations of older adults in television advertisements

The purpose of the present study was to examine a comprehensive set of television advertisements, across networks and times of day, to determine how older adults are portrayed. Older adults appeared in 15% of advertisements, and in those ads, older women were underrepresented relative to men, and older adults appeared less frequently on youth-oriented networks and during the evening. Older adults tended to play incidental roles in the advertisements and to promote a circumscribed, stereotyped set of products and services. Moreover, their characters portrayed overwhelmingly positive attributes and traits. Results from the current study suggest ways in which portrayals in television advertisements might shape attitudes that viewers have about older adults and aging.     

Screening for elder abuse in hospitalized older adults with dementia

When older adults with dementia are hospitalized for psychiatric treatment, which elder abuse screen to use is questionable. This article reviews screens to identify desirable characteristics. For clinician completion, the Elder Assessment Instrument and the Brief Abuse Screens for the Elderly are recommended. For the older adult, the brief Hwalek-Sengstock Elder Abuse Screening Test is suitable. The Modified Conflict Tactics Scale, which can be used by both the older adult and the nonprofessional caregiver, has many of the recommended characteristics. Research is necessary in the application of these screens within hospitals to detect elder abuse within this specialized population.