the canadian gerontological nurse - Canadian Gerontological Nursing ...

THE CANADIAN GERONTOLOGICAL NURSE

Vol. 26 #1 Newsletter of the Canadian Gerontological Nursing Association Summer 2009

PRESIDENT’S MESSAGE It is amazing how quickly a year can fly by in the blink of an eye. My role over this past year as President Elect, has involved the awarding of several bursaries and scholarships to very deserving members to help them to be able to complete their academic endeavors. We are very fortunate to have the Ann C. Beckingham awards for nurses at the graduate level. This nurse left our organization a very large monetary gift that has been invested wisely and will allow us to continue to grant these generous awards for years to come. Another of my main activities has been related to communication with our national members. This has been with our website and via email. Suggestions are always welcomed to help improve our organization so please let me know your ideas and suggestions. I was required to take a leave of absence from the executive for medical reasons and I am very grateful for the executive taking over my responsibilities. The executive have met regularly by teleconference and augment these meetings with phone calls and email. Thank goodness for technology. Thanks to our national board and executive for all their hard work to promote our organization and support our members. Belinda Parke also deserves a special acknowledgement for her leadership, guidance and dedication over the past two years. Taking over the national presidency in Banff was an honour and a privilege. I believe the energy at a CGNA conference can not be duplicated. The wonderful weather and the majestic mountains were our backdrop for this wonderful experience. The opening Ceremonies were very symbolic with the parade of provincial flags being carried in by the provincial presidents/representatives started off the conference with a sense of unity. A highlight for me was getting to know one of our founding members Jessie Mantle who proudly shared her CNA Centennial Medal and described the symbolism in the design of the medal. The Keynote speakers provided us with inspiration from a wide variety of backgrounds and experiences. The quality and quantity of the paper and poster presentations increased our knowledge of best practice initiatives for elder care and the breadth and variety of work taking place in a variety of health care settings. The richness of the experience was augmented by meeting the participants from across the country and around the world. It was a great feeling to award three $5,000.00 Ann C. Beckingham Awards to very deserving graduate students and one $2,000.00 award to a very deserving undergraduate student. Our hosts ordered perfect weather for the gala “Springtime in the Rockies”, and as usual the silent auction created some friendly competition in bidding for the perfect item to take home. The wonderful meal and entertainment kept us going into the night. The Annual General meeting was a very positive and interactive meeting. As usual Gerontological nurses from across Canada stepped up to volunteer to run for, and be elected to our vacated, outgoing executive positions. 1 Vol. 26(1) www.cgna.net

A very special thank you to our outgoing executive Belinda Parke, Diane Buchanan, Denise Levesque and Sandi Hirst. A warm welcome to our new executive members Diane Buchanan, Belinda Parke, Bonnie Hall, and Cheryl Knight. Congratulations to our Alberta hosts, Kathleen Hunter and Sharon Moore and their very hard working team of volunteers for a very successful conference. Respectfully Submitted, Beverley Laurila, RN, BN, MSA, GNC(C)-President CGNA PAST PRESIDENT’S MESSAGE

June 2009 marks the end of my tenure as CGNA President. The past two years have been stimulating, and a time of growth for me personally. Our organization has been challenged on many fronts as we strive to live in a world of financial crisis and changing times within the nursing culture and Canadian society. In closing I would like to express my sincere appreciation to you for providing me the opportunity to serve. I wish acknowledge the work of the board and executive. I appreciate their effort in keeping the organization focused in pursuit of our mission – everyone has been diligent and worked hard to keep our programs running. To follow is the report presented at the AGM Banff 2009. ANNUAL GENERAL MEETING PRESIDENT’S REPORT: MAY 27TH 2009 My tenure has seen the continuation of projects begun by past presidents’ Dr. Lorna Guse, who established a partnership with NGNA that culminated in the document, “Prescriptions for Excellence in Gerontological Nurses”, and Dr. Sandi Hirst’s vision for an International Federation for Gerontological Nursing. This last year has focused on three main activities: 1. Maintaining infrastructure support to our members by administrating education, research and scholarship grants; 2. Collaborating in networking and partnership activities; and 3. Reviewing gerontological nursing standards. To accomplish our work we have been assisted by the expertise and a generous contribution of time from many CGNA members. In addition, organizations like the University of Calgary, the University of Alberta, and Athabasca University have given in-kind support to CGNA efforts. We must be grateful while at the same time careful that we do not build expectations that our mission can be achieved solely through volunteerism. I will have more to say about this later in this report. I remain steadfast in my belief that this IS our time to shine – gerontological nurses can be a solution for the issues arising from our country’s demographic shift toward an aged population. In order to move forward critical questions must be asked, risks must be faced, fears set aside, and hard decisions made. This is not new for CGNA as these have been the kind of issues faced by each Executive and the organization since the beginning of CGNA in 1984. History tells us that great leaders and great organizations stay focused and have clarity in the pursuit of their mission; they master fear and doubt 2 Vol. 26(1) www.cgna.net

(both their own and others). More importantly, their pursuits are done in the collective. Let me address each of the three main activities which we have undertaken: 1. Maintaining infrastructure support to our members by administrating education, research and scholarship grants. Currently, our operating systems are fragmented, uncoordinated and time intensive. Business Practice Review: In September 2007, we began a review of CGNA infra structure, systems and processes taking account of the closure of the Granville Street Business Office and the 2007 resolutions to: a) Open CGNA membership to all categories of nurses; and b) Develop certification support for CGNA members preparing for CNA certification. These resolutions are link to CGNA infrastructures and how CGNA conducts its business affairs. For example, opening up our membership is a bylaw issue with future consequences for CGNA’s relationship with CNA and conjoint members. The structure of our membership dues, and information gathering, coordination, and executive workload are other implications. The business review would provide a comprehensive understanding of the implications and best strategies to move into the future and toward the 2007 resolutions. 2007 Resolution to open up the membership: I continue to believe that we must take an investigative approach to gather all the information in order to understand how best to proceed and the consequences of all available options; I believe the decisions made by the board and executive must be tied to a future vision for CGNA. This must be a coordinated, focused, and time limited process. Consultations were held with select past CGNA presidents and CGNA members, and Dr Ginette Rodger (August 2008) to gather information on best options to move forward. All those consulted recommended beginning by evaluating our vision and mission. We have been encouraged to determine: • Why do we exist? •

Why is it compelling that we stay together?

•

What is different about CGNA, our uniqueness or our niche?

•

What do we represent? and

•

Who do we represent?

Our business practice review must be linked to what defines us and determining what is key to CGNA success, and finally, how do we make our work visible? A working group (Sandi Hirst and Ruth Graham) was struck by the executive (June 2008) to develop a way to move forward on the first resolution but a volunteer to lead this work forward was not found and consequently, the plan could not be executed. Other proposals from organizations providing nonprofit association business and management services (e.g., membership list management, coordinating services, business office services, bookkeeping, website management, conference planning) were also reviewed. Concerns remain regarding the most appropriate action to take and the costs associated with future development of CGNA. Action on these proposals will constitute a major activity for the new Executive and Board. Collaborating in networking and partnership activities A major activity during the year has been our work in networking. I will go through the items of interest to you one by one. International Federation of Gerontological Nurses: We are pleased to host the first International Federation Gerontological Nursing Federation meeting in Banff 2009. Nine countries are represented. 3 Vol. 26(1) www.cgna.net

At this, the first inaugural meeting we hope to establish a plan for next steps. How this intuitive will be lead in the future must be determined. We have extended our discussions with the Canadian Geriatric Society to work on joint projects related to promoting the image of gerontological nurses and geriatricians. In April 2008 we accepted an invitation by the Canadian Geriatric Society to participate in a Coalition to Improve Medical Care for Seniors across Canada. We continue to have teleconferences. This coalition has become broader – the shift is now interdisciplinary education and recruitment – the group has adopted the name GERI (Geriatric Education and Recruitment Initiative). Membership is CARP, NICE, CGS, CAGP [Canadian Association Geriatric Psychiatry], CCSMH [Canadian Coalition on Senior’s Mental Health. A proposal has been written to Industry Canada for funds to promote the work, which we were granted by Health Human Resource Strategies Division – Industry Canada. These funds are held by NICE (National Initiative for Care of the Elderly). A letter was also written to HSBC for corporate sponsorship because they are portraying a positive view of aging in the advertisements. CGNA contributed financial support to have a logo created for GERI. CIHR - IA funding to support research at the conference for a knowledge translation symposium has been awarded to CGNA (7500.00). This work is in keeping with the research strategic plan that was developed by Dr. Hunter and approved by the CGNA Board in 2007. This year we had hoped to award two research grants but unfortunately that has not occurred because of time constraints. Canadian Nurses Association (CNA). Maximizing Health Human Resources: Valuing Unregulated Health Workers Round table discussions – Invitation to these round table discussions were accepted. Thank you to Dawn Winterhalt and Bonnie Hall for representing CGNA at these meetings. Thank you to Dr Carole-Lynne LeNavenec Newsletter editor for publishing these reports for the membership to read. President Elect Bev Laurila updated the listserve – currently 300 names are posted on the listserve distribution list but we have over 800 members in CGNA. We contracted a project person to bring the list serve up to date. Our challenge is to maintain and continually update the listserve. Should the listserve be discontinued? How could the listserve be maintained? These are two examples of questions a business review would help answer. It is costly and time intensive to perform periodic updating. Following the signing of the memorandum of agreement for Ontario Gerontological Nurses Group conjoint membership, a face to face meeting was held in Ottawa during the CNA conference in June 2007. Since that meeting GNA president and I have had several teleconference calls regarding next steps. Questions continue to be raised about the financial viability for GNA. Interest remains high; discussions continue but no resolution has occurred at the printing of this report. CNA Centennial Award – Denise Leveque worked with conjoint provincial presidents to ensure that our Centennial Award recipient Jessie Mantel had a truly joyous experience. Many contributed, thank you to everyone. We acknowledge Sandra Stec for her coordinating efforts in Ottawa. 2. Gerontological Nursing Standards Working Group Review of the standards is underway. National and International representatives have teleconferenced twice and will meet face to face in Banff May 2009. A follow up teleconference will be held in the fall. The work is intended to be completed by December 2009. Members are being sought to fill the role of external reviewers. Co chair leaders are needed for this initiative. Issues Facing CGNA in the Future

4 Vol. 26(1) www.cgna.net

1. People power Our reliance on volunteerism for all aspects of our day to day functioning affects our capacity. We are operating on a “false economy” - our organizational capacity is based on the good will, energy and availability of members, which often is few. The skill requirements to running a charitable organization in this country have changed. Maintaining a focus on our mission as a volunteer organization is a challenge. We lack people power; few are taking on more in order to keep this association progressive. We are challenged to maintain efforts on our strategic plan. 2. Primary funding Our primary funding source is conference profit. Sustainability on this funding model is in jeopardy. Rules and regulations, competition for conference attendees and corporate sponsorship, in addition to the complexity and time required for conference planning adds another layer. The 2011 conference location remains undecided: GNA has expressed an interest to partner with CGNA on this issue – we are awaiting details of their proposal. 3. Becoming a “Go-To” organization We are not seen as the “go-to” organization in Canada for gerontological nursing. Our voice is absent in political circles – the question remains, does the membership want that voice? Political advocacy issues related to our mission of improving health care services for older people and the workplace environment where nurses work are stalled at this time. These and other questions must be asked in light of what we want CGNA to become in the years ahead. The hard part is embracing the fear of “doing the wrong thing” and acting with the best information we have available at this time. Executing the action plan within diminishing people power in a tradition of volunteerism when the answers are uncertain is difficult without a doubt, but (borrowing from President Obama). We can do it! So let’s get started if we don’t want to fade away. Respectfully submitted B. Parke, CGNA Past President Faculty of Nursing 3rd Floor, Clinical Sciences Building Edmonton, Alberta Canada T6G 2G3 NOTE FROM THE EDITOR

As editor of the Canadian Gerontological Nurse, I produced four issues this past year. The issues are getting larger and more colourful since our move to email distribution last year. Contributions are welcome from all members and chapters at any time. However, if you wish to have it in our next/September issue, please send it to me by September 1, 2009. We have been striving to increase the emphasis on research and completed projects and where possible, direct links to the full articles are provided. Our notice in each newsletter about fees for advertisements are evoking an increased number of requests for such advertisements. Please encourage your colleagues to consider advertising in our very dynamic, interesting newsletter. See last page of this newsletter for the outline of the rates. Many of us were fortunate to be able to attend the CGNA Conference in Banff. However, for those who could not attend, please let me know if you need any assistance to track down the various abstracts of papers that were listed on the website. There were a variety of topics covered about how we can all go 5 Vol. 26(1) www.cgna.net

about “Making Moments Matter.” I would like to suggest you watch carefully for an upcoming book by one of the keynote speaker: Perry, B. (to be released in summer 2009). More moments in time: Images of exemplary nursing. Athabasca, AB: AU Press. ISBN 978-1-897425-51-0 (Soft cover). $ CAD 29.95. Order info: [email protected] Please send your submission for the next CGNA newsletter (which will be going out in mid-September) to me by September 1, 2009 to [email protected]. Happy Summer to you all! Carole-Lynne Le Navenec, CGNA Editor [email protected]

TREASURER’S REPORT

I have just returned home from attending the CGNA’s Biennial conference and AGM in Banff. Big “Thank you’s” to not only the planning committee and presenters but also all of the attendees/participants. All of you, your work and involvement, are necessary for a successful conference. Grant and Thornton e-mailed audited year-end statements just in time for our AGM. For those of you who missed the meeting (or did but still have questions), please contact me directly and I will strive to answer your inquiries. One of my goals as Treasurer is to make my reports to you, the Board and the Executive as open, transparent, and understandable as possible. I am honored by your support and trust as evidenced by the approval of the budget as presented at the AGM. Thank you to Cheryl Knight for accepting the nomination for position of Treasurer-Elect. I look forward to the upcoming year when I will try to pass on what I have learned about this role. The Resolution passed at the AGM will see changes and excitement as we sort out the details. I look forward to the coming year. Respectfully submitted by Denise Levesque, CGNA Treasurer June 2009

TREASURER ELECT

Cheryl Knight, RN MN GNC(C) Mrs. Knight is an Executive Director, Seniors Health in Alberta Health Services. Throughout her career Cheryl has had the opportunity to work in many aspects of seniors and continuing care services including psychogeriatric assessment, long term care placement, consultation and senior administration. Cheryl is a Certified Gerontological Nurses and is a long term member of the Canadian Gerontological Nursing Association. She has belonged to the Alberta Gerontological Nurses Association since inception and in 1999 was presented with honorary membership.


REPORTS FROM CGNA PROVINCIAL REPRESENTATIVES

Report from the Saskatchewan Gerontological Nurses Association Respectfully submitted June 2009, Dawn S. Winterhalt President SGNA We entered spring 2009 with continued cold temperatures and snow even into May. The Annual Education Day reunited colleges from around the province in April. Topics included: Wound Care, Stroke Overview, Identifying ‘Red Flag Drugs in the Elderly’, Antibiotic Resistant Organisms and Practical Approaches for Dealing with Difficult Behaviors. We had sought a larger venue so we did not have to turn participants away and in the end we educated 158 participants. I would like to offer special thanks to the current executive, our numerous vendors and sponsors for their contributions to making our education day a huge success. With the recent development of our website, we look forward to further evolution of the site to include online registration and paperless dissemination of information to our membership. On a more serious note, we had a number of executive positions available and presented for nomination during the annual meeting. I strongly encouraged the membership to get involved in any way possible. With overwhelming success of the Education Day; the executive is excited to know that there are folks out there who devote themselves everyday to the care of the older person. However, we had little interest by the members to become involved in the executive. I found that lack of interest to get involved very discouraging. The fate of the association rests with our current executive and our members. Stay tuned! We invite you to explore the opportunity to be a part of this association! Everyday amazing residents, volunteers and staff show us each the true meaning of living a full life. Keep up the great work everyone!

True Tale The new intern decided he would help out and take a temperature. After several attempts, he was puzzled by why he couldn’t get it. I went with him to see what was going on. It was a digital ear thermometer, but he had it in the patient’s mouth. Of course, I had to set him straight, even if it did embarrass him.


REFLECTIONS ABOUT QUALITY CARE FOR OLDER ADULTS

IMPACT ANSWERS by Sandra P. Hirst RN, PhD, GNC(C) and Carole Lynne LeNavenec RN, PhD (Email: [email protected] and [email protected]) Daily in our nursing practice, we ask ourselves such questions as: •

What do I need to know about how to walk with the older resident who wanders?

•

How do I teach an older adult who is blind about his diabetic diet?

•

How do I encourage a spouse to consider her health when she comes in every day to the facility to feed her husband his lunch and dinner?

We are seeking impact answers, in other words – what actions can I take to promote or maximize my nursing care to this older adult and those important to his or her? Impact answers are drawn from evidence, which range from “expert” opinions, to lay evidence (urban legends), to research based evidence. Evidence informed practice, sometimes called evidence based practice, is a concept which has been increasingly cited in health care and nursing policy development in recent years. We heard it discussed in several different forums during the 15th Conference on Gerontological Nursing, recently held in Banff, Alberta. It is based upon the principle that the development and implementation of intervention s, in this case nursing actions, are informed by the most current, relevant, and reliable evidence about their effectiveness. However, we also heard during this same conference questions as to how one could access such evidence. Part of the challenge of getting evidence into practice is finding the evidence. There are a number of Canadian resources that might be of use to you in your practice: •

Canadian Institutes for Health Research integrate research through an interdisciplinary structure comprised of 13 "virtual" institutes, or networks of researchers brought together to focus on important health problems, of which the Institute of Aging is one. http://www.cihr-irsc.gc.ca

•

Canadian Medical Association InfoBase is a public database of evidence-based clinical practice guidelines (CPGs). Maintained by the Canadian Medical Association, it currently includes over 1200 CPGs developed or endorsed by an authorative medical or health organization in Canada. http://www.cma.ca/index.cfm/ci_id/54316/la_id/1.htm


•

National Initiative for Care of the Elderly (NICE) is an international network of researchers, practitioners and students dedicated to improving the care of older adults, both in Canada and abroad. www.nicenet.ca/

•

Public Health Agency of Canada – Policy Research Unit whose work is to strengthen and promote evidence-based decision-making by providing strategic information to policy processes and program development in the Public Health Agency of Canada. http://www.phacaspc.gc.ca/php-psp/pru-eng.php

•

Registered Nurses Association of Ontario has on its site 29 Best Practice Guidelines as well as a Toolkit and Educator's Resource to support implementation. http://www.rnao.org/Page.asp?PageID=861&SiteNodeID=133

You may wish to go broader afield in your pursuit of evidence, try: •

Cochrane Collaboration is an international network of individuals and institutions committed to preparing, maintaining, and disseminating systematic reviews of the effects of health care. http://www.cochrane.org

•

National Guidelines Clearing House (NGC) a public resource for evidence-based clinical practice guidelines. It is an initiative of the Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services. http://www.guideline.gov/

•

University of Iowa Gerontological Nursing Intervention Research Center (GNIRC) strengthens and expands intervention focused research in nursing and related disciplines regarding the health of elders in a variety of care. They have produced 38 evidence-based nursing practice guidelines. http://www.nursing.uiowa.edu/products_services/evidence_based.htm

The value of such sites is that a critical appraisal of the literature has already been done for us. In other words, we do not need to start from scratch in our search for evidence. In brief, evidence informed gerontological nursing care is the process of distilling and disseminating the best available evidence and using it to inform and improve the nursing care of older adults – simply stated, it is finding, using, and sharing what works in gerontological nursing practice. And it promotes what some label as “Healthy Aging” http://www.phac-aspc.gc.ca/seniors-aines/pubs/cds/daw/cddaw_e.htm


CALL FOR NOMINATIONS for CNA Order of Merit for Clinical Nursing Practice CNA Order of Merit for Nursing Administration CNA Order of Merit for Nursing Education CNA Order of Merit for Nursing Research CNA Order of Merit for Nursing Policy Please find attached the Call for Nominations and nomination form for the CNA Order of Merit 2010. Your assistance in disseminating this information will be appreciated. The Call will also appear on CNA's website. Criteria and nomination form are attached. Your assistance in disseminating this information will be appreciated. Complete documentation must include o o o o

The attached nomination form, completed in full by the nominator. A minimum of three (3) letters from individuals in support of the nomination. The nominee's curriculum vitae. A biographical note no longer than one page.

ACTION: send nomination form with all supporting documents to Anna Baker, Governance Coordinator, CNA House, by 15 January 2010. Please note that only those nominations that are completed in full and sent by 23:59 hours on 15 January 2010 will be considered. Electronic submissions are encouraged. If you have any questions, please contact: Anna Baker Governance Coordinator Canadian Nurses Association 50 Driveway, Ottawa ON Canada K2P 1E2 Tel: (613) 237-2159 x 221 Fax/: (613) 237-5275 Email: [email protected] Website: www.cna-aiic.ca


NOMINATION FORM FOR ORDER OF MERIT in Nursing Clinical Practice, Administration, Education, Research OR Policy Please note that only those nomination forms that are completed in full with supporting documents and received by 23:59 on January 15, 2010, will be considered. Forms should not advise "see attached c.v." where specific information has been requested. Information on the nominee's work experience and accomplishments in the three major criteria must be included in the space provided.

1. PLEASE INDICATE WITH AN “X” WHICH DOMAIN THE NOMINATION IS FOR: CNA Order of Merit for Clinical Nursing Practice CNA Order of Merit for Nursing Administration CNA Order of Merit for Nursing Education CNA Order of Merit for Nursing Research CNA Order of Merit for Nursing Policy

2. DATE:

3. NOMINATOR NAME of jurisdiction or associate member, hospital, university, individual, etc: NAME of contact person: E-MAIL address of contact person:

4. NOMINEE SURNAME: GIVEN NAMES: PRESENT OCCUPATION OR POSITION: COMPLETE MAILING ADDRESS (including city, province and postal code): TELEPHONE (with area code): Business: Home: FAX (with area code): 11 Vol. 26(1) www.cgna.net

E-MAIL address: HAVE YOU RECEIVED CONSENT from the nominee to let their name stand for nomination for the CNA Order of Merit? (Not relevant if nominee is deceased) HAVE YOU INFORMED the nominee that his/her name will be made public if the nomination has met the criteria? IS OR WAS THE NOMINEE A CANADIAN CITIZEN? IS OR WAS THE NOMINEE IN GOOD STANDING WITH A CNA MEMBER JURISDICTION? (Name the jurisdiction) PRIVACY POLICY: Personal information collected on this form will be used only for processing nominations and related follow-up.

5. SUMMARY OF NOMINEE'S WORK EXPERIENCE Fill in (150 words maximum)

6. SUMMARY OF OTHER MAJOR ACCOMPLISHMENTS (E.G., VOLUNTEER ACTIVITIES, AWARDS, ETC.)

Fill in (150 words maximum)

7. LIST THE SPECIFIC ACCOMPLISHMENTS DIRECTLY RELATED TO CRITERIA #1 1. Canadian nurses who have made a significant and innovative contribution to the health care of Canadians by: • creating or assisting in the organization and implementation of new health care/education/research programs; and • demonstrating expertise that results in a marked improvement in the health-care delivery system. Fill in

8. LIST THE SPECIFIC ACCOMPLISHMENTS DIRECTLY RELATED TO CRITERIA #2 2. Canadian nurses whose activities at the national level have resulted in increased status and public recognition for the nursing profession as a whole. These activities may be evidenced by: • outstanding contribution to national organizations such as CNA and organizations related to the nominee’s primary domain of practice; • leadership and service within CNA or organizations related to the nominee’s primary domain of practice; • demonstrated leadership in the advancement/promotion of nursing in the public or private sector; • advancement of nursing theory/research in the primary domain of practice.

Fill in

9. LIST THE SPECIFIC ACCOMPLISHMENTS DIRECTLY RELATED TO CRITERIA #3 for ONE of the following domain nominations: 3. Canadian nurses whose personal contribution has had a significant and sustained positive impact on the nursing profession and practice of nursing in Canada in one of the following domains: clinical practice, 12 Vol. 26(1) www.cgna.net

education, administration, research and policy. a) Clinical Nursing Practice The contribution in the clinical nursing practice domain may be evidenced by: • in-depth of knowledge of clinical area and an outstanding ability to deliver holistic care; • demonstrated initiative in influencing positive changes in care delivery using evidence-based practice; • demonstrated innovation in the delivery of care; • actively advocating for and fostering a culture that promotes quality care; • actively sharing his/her expertise and knowledge of best practices in clinical nursing practice with colleagues across the country through presentations, publications and committee participation. Fill in if applicable OR ignore

b) Nursing Education The contribution in the nursing education domain may be evidenced by: • creativity, innovation and flexibility in motivating learners; • leadership in promoting excellence in nursing education within academic and practice settings; • identifying emerging trends in health care and working proactively to initiate changes in programs and curriculum; • consistently demonstrating a commitment to improving quality of health care through nursing education; • actively sharing his/her expertise and knowledge of best practices in nursing education with colleagues across the country through presentations, publications and committee participation. Fill in if applicable OR ignore

c) Nursing Administration The contribution in the nursing administration domain may be evidenced by: • promoting workplace cultures in which nurses and other health-care providers are positive, challenged and involved; • promoting incorporation of new nursing knowledge and utilization of research findings in healthcare settings; • improving health-care delivery through evidence-based changes that improve effectiveness and efficiency; • advocating for nurses and nursing in health-care settings; • actively sharing his/her expertise and knowledge of best practices in nursing administration with colleagues across the country through presentations, publications and committee participation. Fill in if applicable OR ignore

d) Nursing Research The contribution in the nursing research domain may be evidenced by: • a sustained program of research activity advancing development of clinically relevant nursing knowledge, nursing education, nursing administration and policy development; • promoting nursing research and the application of research findings in practice settings; • obtaining research funding from a variety of sources including national health-care research funding agencies; • actively sharing his/her expertise and knowledge of best practices in nursing research with colleagues across the country through presentations, publications and committee participation.


Fill in if applicable OR ignore

e) Nursing Policy The contribution in the nursing policy domain may be evidenced by: • identifying emerging issues and providing leadership to positively influence the quality of health care for Canadians through evidence-based policy-making including regulation of the profession; • advocating for nurses and nursing with governments, other health-care professionals and the public; • developing clear understanding of issues by consulting widely with those who will be affected by policy decisions and fostering partnerships between stakeholder groups; • actively sharing his/her expertise and knowledge of best practices in nursing policy development with colleagues across the country through presentations, publications and committee participation. Fill in if applicable OR ignore

PLEASE NOTE THE FOLLOWING DOCUMENTS MUST ACCOMPANY THE NOMINATION FORM (electronic submissions are encouraged): • a minimum of three (3) letters from individuals in support of the nomination. This can include a letter from the nominator; • the nominee's curriculum vitae; and • a biographical note no longer than one page. PLEASE RETURN THE NOMINATION FORM and SUPPORTING DOCUMENTS NO LATER THAN 23:59 on JANUARY 15, 2010, TO: Governance Coordinator Canadian Nurses Association 50 Driveway, Ottawa, Ontario K2P 1E2 E-mail: [email protected] Fax: (613) 237-5275

NEW DVDs

Over the next several issues, we will have the pleasure of introducing you to a series of new DVDs, specific to gerontological nursing practice. Each one of the DVDs in this collection employs a critical-thinking, evidence-based approach to assessment and intervention specific to common health issues of older adults. The 28 series includes the following titles: • Delirium: The Under-Recognized Medical Emergency • Eating and Feeding Issues in Older Adults with Dementia • Elder Mistreatment Assessment • Fulmer SPICES: An Overall Assessment Tool for Older Adults • The Modified Caregiver Strain Index • •

The Pittsburgh Sleep Quality Index Preventing Aspiration in Older Adults with Dysphagia 14 Vol. 26(1) www.cgna.net

•

The Short Michigan Alcoholism Screening Test – Geriatric Version

We will review one or more of the DVDs in this series as an ongoing information item in the CGNA newsletter. The focus in this issue is Elder Mistreatment Assessment – 39 minutes. From the perspective of content, the DVD’s division into two chapters is useful: the first provides an overview of how to assess an older adult using the Elder Assessment Instrument. It takes a realistic look at some of the potential challenges associated with an accurate assessment, such as the older adult’s possible hesitancy in the sharing of information. One of the strengths of this specific section is that it provides a debriefing with a nursing student and a geriatric nurse practitioner to provide a context to the administration and use of the tool. The content will help practitioners to identify possible abandonment, abuse, exploitative, and neglect indicators and to identify response strategies. The second chapter provides definitions of these same terms by Terry Fulmer, an internationally recognized expert in this area. One has the choice of watching either or both chapters, which is useful as often viewing time is limited. The interesting context for me was that I was at the PREVNet* conference in Toronto this past week, which included a workshop on abuse of older adults. This would have been an excellent resource for many in attendance. The fact that the series was produced by Terra Nova Films, Inc. for the American Journal of Nursing speaks to the credibility of the series and to the relevance of the content to professional nursing practice. For further contact details: Terra Nova Films, Inc. Toll Free: 800-779-8491 Fax: 773-881-3368 Phone: 773-881-8491 e-mail [email protected] Reviewed by Sandra P. Hirst RN, GNC(C) Director, Brenda Strafford Centre for Excellence in Gerontological Nursing • PREVNet is a Canadian network of researchers, non-governmental organizations and governments committed to stop bullying. It is one of the Networks of Centres for Excellence funded by the federal government.

BETWEEN THE EAR TROUBLE A blonde called the nurse help line in a panic. She had a fly in her ear and didn’t know what to do. The veteran nurse suggested an old folk remedy. “Pour warm olive oil in your ear and lie down for a couple of minutes, she said. “When you lift your head, the fly should emerge with the liquid.” “That makes sense, said the blonde. “I have one question: which ear should I put the oil in?” The veteran nurse was taken aback momentarily, then replied, “Apparently, either will work.”


SUMMER 2009 VACATION READING LIST

JOURNAL/ BOOK SOURCE Canadian Journal on Aging, 27 (4) Winter 2008

SUBJECT/ RESEARCH METHOD / MODEL

AUTHOR & YEAR

TITLE OF ARTICLE / KEY CONTENT AREAS

End of Life Care model/Health Care Services

Wilson, Birch, Sheps, Thomas, Justice, & MacLeod (2008)

Researching a best-practice end-of-life care model for Canada

CJA, 27(4), Winter 2008

Falls / Ethnography

Preventing falls within a family context: A focused ethnographic approach

CJA, 27(4), Winter 2008

Care needs of older adults with COPD living at home/Ethnography

CJA, 27(4), Winter 2008

Knowledge of older adults about Community Support Services

CJA, 27(4), Winter 2008

Volunteerism among older adults /Civic Engagement

Kilian, Salmoni, Ward-Griffen, & Kloseck (2008) Wilson, Ross, Goodridge, Davis, Landreville, & Roebuck Denton, Ploeg, Tindale, Hutchinson, Brazil, AkhtarDanesh, Quinland, Lillies, Plenderleith, & Boos (2008) Gottlieb & Gillespie, 2008

Gerontological Nursing: Competencies for Care

Contents as follows: Critical thinking competencies, Communication competencies, Assessment and Technical Skills, Health Promotion, Risk Reduction and Disease Prevention Competencies, continued in Column 4.

Mauk, K.L., Professor of Nursing, Valparaiso University, Indiana (2009)

Cont’d from Column 2 … Illness and Disease Management Competencies, Information and Health Care Technologies Competencies … Human Diversity Competency, Global Health Care, Health Care Systems and Policy Competencies. Member of a Profession Competency.

Mentoring in Nursing: A dynamic and collaborative process

Mentoring/Coaching /Preceptorship

Grossman, S.C. (2007)

Mentoring from a classic dyad to a dynamic network; Vision of the mentoring culture in nursing; Empowering versus enabling; Strategies for developing mentorships in nursing; The mentor perspective on how best to encourage others; The mentee perspective on how best to become empowered.

Short form for journal: CJA, 27(4), Winter 2008


The care needs of community-dwelling seniors suffering from advanced chronic obstructive pulmonary disease Where would you turn for help? Older adults’ awareness of community support services.

Volunteerism, health and civic engagement among older adults

RESEARCH

See News from Various Centres of Gerontology: News about McMaster Centre for Gerontological Studies, McMaster University, Hamilton, Ontario: http://dailynews.mcmaster.ca/story.cfm?id=6048 See also www.socsci.mcmaster.ca/gerontology See also Hartford Institute for Geriatric Nursing, April 2009 e-Newsletter in the Other Reports/Newsletter section. Miscellaneous Research Reports AD: Effect of Pain killers on onset of the disease http://uk.reuters.com/article/email/idUKN2250407420090422 For funding opportunities be sure to check the website for the Canadian Institute for Health Research (CIHR). For infor: http://www.cihr-irsc.gc.ca/e/193.html

BATTER UP The star of the nurses’ softball team brought his bat to work with him on the day of a game. Seeing him in the hall, an ornery patient said to one of the other nurses, “What’s that thug doing walking around here with a baseball bat?” “That’s no thug, dear,” the nurse replied. “That’s your anesthesiologist.”

UPCOMINGth EVENTS

Revised March 16 2009


INTERNATIONAL COUNCIL OF NURSES 24TH QUADRENNIAL CONGRESS: LEADING CHANGE: BUILDING HEALTHIER NATIONS June 27 - July 4, 2009 Durban, South Africa More details at http://www.icn.ch/congress2009.htm THE IAGG WORLD CONGRESS July 5-9, 2009 Paris, France www.gerontologyparis2009.com INTERNATIONAL NURSING RESEARCH CONGRESS FOCUSING ON EVIDENCE-BASED PRACTICE (SIGMA THETA TAU) July 13-17, 2009 Vancouver, BC Details at http://www.nursingsociety.org/STTIEvents/ResearchCongress/Pages/congress.aspx TEACHING FOR & FROM PRACTICE: CRITICAL CONVERSATIONS ABOUT EDUCATION August 24-26, 2009 Abstract submission deadline is June 1, 2009 Details at http://nursing.ucalgary.ca/2009TDUconference More information at http://www.buksa.com/halifax/program.htm DEMENTIA SERVICES DEVELOPMENT CENTRE'S 3RD INTERNATIONAL CONFERENCE: FACING THE FUTURE September 15-16, 2009 Stirling, Scotland Details at http://www.dementia.stir.ac.uk/conferences.asp 26TH INTERNATIONAL CONFERENCE OF ISQUA, THE INTERNATIONAL SOCIETY FOR QUALITY IN HEALTH CARE October 11-14, 2009 Dublin, IE Details at http://www.isqua.org/Dublin2009InternationalSocietyforQualityinHealthCareLtd.html CANADIAN FEDERATION OF MENTAL HEALTH NURSES 2009 NATIONAL CONFERENCE "HOPE, HEALTH, AND HEALING: MENTAL HEALTH NURSING AROUND THE CORNER AND AROUND THE WORLD" October 21-23, 2009 Halifax, NS Call for abstracts coming soon. More details at www.cdha.nshealth.ca/default.aspx?page=RNPDC¢erContent.Id.0=23087&category.Categories.1=352 CANADIAN ASSOCIATION ON GERONTOLOGY (CAG) 2009 CONFERENCE Fairmont Hotel, Winnipeg October 22-24, 2009 Info: www.cagacg.ca 10TH ANNUAL INTERDISCIPLINARY RESEARCH CONFERENCE "TRANSFORMING HEALTHCARE THROUGH RESEARCH" November 4-6, 2009 Dublin, Ireland More details at http://www.nursing-midwifery.tcd.ie/events/ 6TH ANNUAL DIVERSITY AND WELL-BEING CONFERENCE: FROM MONOLOGUE TO DIALOGUE: PROMOTING HEALTH LITERACY WITH DIVERSE POPULATIONS November 19 & 20, 2009 Calgary, AB Abstract submission deadline is June 26, 2009 Details at http://www.calgaryhealthregion.ca/programs/diversity/news_events/conference_09.htm SHANGHAI INTERNATIONAL NURSING CONFERENCE: NURSING MAKES HEALTHIER LIVES November 17-20, 2009 Shanghai, China Abstract submission deadline is August 31, 2009 More details at http://www.shinc.cn JOANNA BRIGGS INSTITUTE 2009 CONVENTION: RIPPLES TO REVOLUTION: FROM BENCH TO BEDSIDE November 18-20, 2009 Adelaide, Australia Details at http://www.joannabriggs.edu.au/events/2009JBIConv/index.html HEALTH MEANS THE WORLD TO US: CANADIAN REFUGEE HEALTH CONFERENCE November 24-25, 2009 Toronto, ON Details at http://events.cmetoronto.ca/website/index/INT0933 18 Vol. 26(1) www.cgna.net

TRANSFORMING NURSING THROUGH KNOWLEDGE - SHARING GLOBAL VISIONS & LOCAL SOLUTIONS December 2-4, 2009 Toronto, ON More details at http://www.rnao.org/Page.asp?PageID=1209&ContentID=2691&SiteNodeID=196&BL_ExpandID= IPNR CONFERENCE: PHILOSOPHY IN THE NURSE’S WORLD: POLITICS OF NURSING PRACTICE May 16 to 18, 2010 Banff, AB Abstract submission deadline is December 1, 2009 Details at http://www.uofaweb.ualberta.ca/nursing/ipnr.cfm

BOOK REVIEWS / NEW BOOKS

BOOK REVIEW of: De Geest, G. (2007). The LIVING DEMENTIA case study approach. Victoria, BC & Oxford, UK: Trafford. 190 pages. Paperback $CAD: 20.00. ISBN: 142511647-7 Both family and professional care partners will breathe a sigh of relief after reading The Living Dementia Case-Study Approach. It is a clearly written and very practical account about what these groups have found best addresses their needs, and what does not. The case studies put the reader right “in the room” with the person needing care, seeing the person and situation through the eyes of both the family members and professional caregivers. The suggested reading that is included at the end of some of the chapters should also facilitate a broader understanding of what some of us call “the illness trajectory” for families who have a relative with this type of chronic illness. Utilizing a person-centered care approach, the book encourages communication and respect between persons with dementia and their care partners and demonstrates simple ways to foster this approach. Similarly, the case study method used for the book affords more information about the social context of this population, and how they go about shaping it as best they can. This book was written by a Master’s prepared Canadian nurse educator who has worked with individuals experiencing dementia and their families. The intent of her book of case studies is to provide a resource for all family members and professional care partners of persons with dementia. The Living Dementia Approach provides creative solutions for those caring for persons with Alzheimer’s disease and related dementias. Illustrative feedback from readers include: ♦ ♦ ♦ ♦ ♦

4-T Dementia Care Model reveals the nature of the lived experience of this journey with dementia I found many useful strategies for managing the behaviours of the person with dementia It is an educational, compassionate and life-affirming book The narratives helped me attach meaning to the phases of the dementia journey Illustrative examples of a range of tools and techniques to more closely connect with these persons, and thereby afford them with opportunities to enhance the quality of their day-to-day life

One daughter shares: "I certainly wish I'd had the information contained in The Living Dementia Approach when I was trying to help and relate to my mother in her last years. If my sister and I and the professional caregivers at the nursing home, had had the insights provided by these case studies and varied scenarios, we would have been able to help her feel more in control of her life, be more comfortable, and be able to share more of her fading memories with us." 19 Vol. 26(1) www.cgna.net

In summary, an informative book of stories that clearly illustrate how nurses and related health care professionals can help to go about creating health in chronic illness contexts, as well as the value of the case study approach for teaching-learning situations. The author has indicated how her group, Cruise Respite Solutions, offers educational seminars for family and professional caregivers, thereby affording them necessary respite from their care giving journey. These seminars are offered aboard a luxury cruise vacation. Further information can be obtained directly from the author at: [email protected] Book Review done by: Dr. Carole Le Navenec, Associate Professor, Faculty of Nursing, University of Calgary, Canada ([email protected])

NEW DVDs .. Cont’d.

BE SURE TO CHECK OUT SOME OF THESE NEW DVDS We will be submitting a review in upcoming newsletters for each of these DVDs. We would encourage readers to send us similar reviews of DVDs that you find particularly useful. These DVDs happen to be from Terra Nova Films and are part of their How to Try This: Assessments and Best Practices in the Care of Older Adults Website: www.terranova.org

SEE PAGES 14 AND 15 FOR REVIEW The series includes the following twenty-eight titles: • • • • •

• • • • • • • •

Assessing Family Preferences for Participation in Care in Hospitalized Older Adults – 36 minutes Assessing Nutrition in Older Adults – 34 minutes Avoiding Restraints in Older Adults with Dementia 41 minutes BEERS Criteria for Potentially Inappropriate Medication Use in Older Adults – 40 minutes Brief Evaluation of Executive Dysfunction: An Essential Refinement in the Assessment of Cognitive Impairment – 36 minutes Communication Difficulties – 41 minutes Delirium: The Under-Recognized Medical Emergency – 51 minutes Eating and Feeding Issues in Older Adults with Dementia – 38 minutes Elder Mistreatment Assessment – 39 minutes Fall Risk Assessment (Hendrich II) – 34 minutes Fulmer SPICES: An Overall Assessment Tool for Older Adults – 20 minutes Geriatric Depression Scale (GDS) Short Form 28 minutes The Hospital Admission Risk Profile (HARP) 43 minutes

•

• • • • • • • • • • • • •

Horowitz Impact of Event Scale--Revised: An Assessment of Post-Traumatic Stress in Older Adults – 40 minutes Katz Index of Independence in Activities of Daily Living – 28 minutes The Lawton Instrumental Activities of Daily Living Scale – 40 minutes Mental Status Assessment (Mini-Cog) 31 minutes The Modified Caregiver Strain Index - 32 minutes Older Adult Sexuality: A Continuing Human Need 37 minutes Pain Assessment in Older Adults – 64 minutes The Pittsburgh Sleep Quality Index – 32 minutes Predicting Pressure Ulcer Risk (Braden Scale) 39 minutes Preventing Aspiration in Older Adults with Dysphagia – 47 minutes Recognition of Dementia in Hospitalized Older Adults – 30 minutes The Short Michigan Alcoholism Screening Test – Geriatric Version (SMAST-G) – 41 minutes Transient Urinary Incontinence in Older Adults 40 minutes Wandering in Hospitalized Older Adults with Dementia – 42 minutes


OTHER REPORTS/ NEWSLETTERS

HARTFORD INSTITUTE FOR GERIATRIC NURSING, APRIL 2009 E-NEWSLETTER Welcome to the Hartford Institute for Geriatric Nursing's eNewsletter featuring articles, reference materials, useful links, calendar of events and other best practice information on the care of older adults. *This eNewsletter is sponsored by ConsultGeriRN.org .* ConsultGeriRN.org is the authoritative geriatric clinical nursing website of (1) the Hartford Institute for Geriatric Nursing, New York University College of Nursing and (2) the NICHE (Nurses Improving Care for Health system Elders) program, (www.nicheprogram.org ). ConsultGeriRN.org contains evidence-based protocols and topics for nurses and other healthcare professionals on the care of older adults. Content is updated regularly. We would like to hear from you! If you have a geriatric-related story, topic or an event you would like featured in our newsletter, please send your request to [email protected] . NEW ISSUE of the /Try This:®/ Series from the Hartford Institute for Geriatric Nursing! ISSUE 26: THE TRANSITIONAL CARE MODEL (TCM): HOSPITAL DISCHARGE SCREENING CRITERIA FOR HIGH RISK OLDER ADULTS. /Try This:®/ a publication of the Hartford Institute for Geriatric Nursing, is a series of assessment tools and best practice approaches to care where each issue focuses on a topic specific to the older adult population. "The Transitional Care Model (TCM): Hospital Discharge Screening Criteria for High Risk Older Adults" authored by M. Brian Bixby and Mary D. Naylor from the 21 Vol. 26(1) www.cgna.net

New Courtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, describes how to identify patients at high risk for poor outcomes after hospitalization for an acute or exacerbated chronic illness. This best practice approach to care highlights those screening criteria, that if positive, should trigger the nurse to implement post-discharge interventions to assure appropriate information transfer and follow-up after discharge to home or other care setting. *View this issue * *View the entire /Try This:®/ series * SPECIALTY NURSING ASSOCIATIONS ENDORSE GLOBAL VISION STATEMENT ON CARE OF OLDER ADULTS Twenty-eight national nursing organizations, including twenty-one specialty associations and seven members of the Coalition of Geriatric Nursing Organizations (CGNO) have endorsed the /Specialty Nursing Association Global Vision Statement on Care of Older Adults/, as of March 30, 2009. The statement emphasizes that, with the rapid increase in the population of U.S. older-adults, the nurse workforce must become equipped to meet their changing and specific health care needs. Older adults constitute the largest group of health care users across all settings, and virtually all nurses care for older adults in their subspecialties. Nurses must be competent to deliver care to older adults, being sensitive to the physiological, functional, and psychological needs that set them apart from younger adults. **MailScanner has detected a possible fraud attempt from "consultgerirn.org" claiming to be* Learn more about the Global Vision Statement on ConsultGeriRN.org * DO YOU KNOW ENOUGH ABOUT SEXUALITY ISSUES IN OLDER ADULTS? Although it is generally believed that sexual desires decrease with age, several researchers have identified that sexual desires, thoughts, and actions continue throughout all decades of life. Human touch and healthy sex lives evoke sentiments of joy, romance, affection, passion, and intimacy, whereas despondency and depression often result from an inability to express one's sexuality. Health care providers play an important role in assessing and managing normal and pathological aging changes in order to improve the sexual health of older adults. **MailScanner has detected a possible fraud attempt from "consultgerirn.org" claiming to be* Learn more about "Sexuality Issues in Aging" with references and resources by visiting ConsultGeriRN.org. * NICHE WEB BASED LEARNING SERIES PRESENTS: /"THE NEVER EVENT SERIES: THE EXPERTS RESPOND"/ NICHE: Nurses Improving Care for Healthsystem Elders Join us as we meet with the experts and explore the most effective practices and protocols for prevention of CMS Never Events. Featured speakers are nationally recognized leaders in the field who have been invited to share the most current 22 Vol. 26(1) www.cgna.net

information and expert advice available. PowerPoint presentations accompany each conference. Live question and answers follow each presentation. * The NICHE program was developed by the Hartford Institute for Geriatric Nursing at NYU College of Nursing to help hospitals make systemic changes in the way they care for older adults. Over 200 hospitals nationally have benefited by integrating NICHE into their facility. TOPIC RESOURCES: HOROWITZ IMPACT OF EVENT SCALE View Article View Video Videos can be watched in their entire format, or in chapters that relate to the specific assessment skills described above. Continuing education hours are also offered. View more information about the series and topics covered. A person may suffer debilitating anxiety and other physical and psychological symptoms without recognizing that they're a response to a traumatic event. And older adults in particular may be reluctant to admit to experiencing such symptoms. The Impact of Event Scale-Revised (IES-R) is an easy-to-administer questionnaire used to evaluate the degree of distress a patient feels in response to trauma. It provides a structured way for a patient to communicate distress when she or he may not have the words to do so. The How to Try This:® series is funded by the John A. Hartford Foundation to the Hartford Institute for Geriatric Nursing at New York University's College of Nursing in collaboration with the American Journal of Nursing (AJN). This initiative translates the evidence-based geriatric assessment tools in the Try This Assessment Series into cost-free, web-based print and video resources, for caring for older adults. This series can be viewed, downloaded, and shared without any fees. Articles may be printed and copied for educational use without copyright fees. View more information THE WORKFORCE STABILITY TOOLKIT Sarah Greene BurgerSarah Greene Burger, RN-C, MPH, FAAN Senior Advisor on Special Projects, Hartford Institute Through a grant from The Commonwealth Fund, Quality Partners of Rhode Island in collaboration with B & F Consulting recently created a useful tool for nursing home leadership The Workforce Stability Toolkit . This toolkit incorporates experiences and lessons learned in over 400 nursing homes. It is designed to serve as a resource for homes just getting started with efforts to reverse turnover as well as employers who have already started to address recruitment and retention and need further assistance in a specific area. The toolkit applies concepts and practices based on the work of Susan Eaton, Ph.D. who, in 2002, completed a CMS funded study, What a Difference Management Makes! This Workforce Stability Toolkit is being offered to nursing homes free of charge and is available for interested parties to view, print and save for future use. *Learn more about the Workforce Stability Toolkit - A Publication From Quality Partners of Rhode Island. 23 Vol. 26(1) www.cgna.net

* For more information about this toolkit, contact *Gail Patry*: [email protected] SOUND OFF! Mathy Mezey EdD, RN, FAAN Professor and Director Hartford Institute for Geriatric Nursing New York University College of Nursing Nurses are accustomed to caring for older adults with clearly diagnosed dementias whose memory loss, inability to find words, and difficulty with eating, dressing and toileting are quite apparent. But a special issue of the March 2009 /Journal of Gerontological Nursing/ emphasizes the good outcomes that nurses can achieve by identifying older adults with /early-stage/ Alzheimer's dementia. Early-stage dementia, a relatively new term, characterizes people with low normal or barely abnormal scores on instruments that assess cognition and dementia (e.g. the Global Deterioration Scale [GDS]), who are aware of a difficulty but are still able to actively participate in healthcare decisions. The earlier the dementia is diagnosed, the better the response to pharmacological and non-pharmacological treatments (e.g. cognitive training). Take a look at this excellent special issue in the /Journal/ and think about how you can identify older adults with early-stage dementia in your practice. LINK TO CONSULTGERIRN.ORG Add a link on your site to ConsultGeriRN.org! hartfordign.org nicheprogram.org consultgerirn.org The Hartford Institute for Geriatric Nursing NYU | 246 Greene St. | New York | NY | 10003

Take a musical break …. And visit the website called the Creative Arts Integrative Therapies in Health Care Research Group. Below is a link for one of the musical features http://www.caitresearchgroup.com/pdf/L-eau-c-beau-v.pps 24 Vol. 26(1) www.cgna.net

ARTICLE from: Elder Wise Vol. 5, No. 4 2009. http://elderwise.ca/

AGING PARENTS AND SIBLING RIVALRY When an aging parent is thrown into a crisis, the whole family is involved. This is a time when siblings might rally around each other and use their strengths to cope with the crisis in a way that serves everyone's best interests. Sometimes, adult children find themselves playing out old roles and scripts with each other. Old feelings of rivalry and competition may get in the way of shared solutions. How can brothers and sisters put aside these patterns when they are forced together to help their aging parents? First, recognize and accept differences. You and your siblings do not necessarily share values, beliefs, and experiences; in fact, you may come from different generations! If you are an "early boomer" born between 1946 -1950, you are close to retirement and likely addressing some of your own aging issues. If your youngest sibling was born 15 years later in the early 60's, you two may not have much in common. This "late boomer" is still involved in work and career and raising children. Next, respect the differences. This is easier said than done, but necessary for working together for a common family goal. This process requires internal work - to abandon judgment and criticism of someone whose views are different from yours. Then, really listen. Possibly the most important communication skill is to become an "active listener." It takes work, but listening to others can help you to find common ground. Here are five tips on being a better listener: • •

Listen at least as much as you talk. Ideally, listen more than you speak. Try to understand (if not agree with) the other's point of view. o Ask for clarification if you do not understand o Give positive - or at least neutral - feedback on their ideas 25 Vol. 26(1) www.cgna.net

• • •

Suspend judgment and assumptions while listening. Listen for the feelings that lie beneath the words. Avoid the temptation to become sarcastic or critical.

Active listening requires intention as well as attention! Each person must truly want what's best for everyone, not just to advance his or her own agenda. Involving an impartial outside party, such as a trusted family friend or advisor - or an Elder Wise coach - can help interrupt these patterns. The presence of an impartial third party in the room is often enough, in itself, to change the tone of family conversations. A skilled coach can also be helpful in framing or reframing the issues, monitoring for good listening skills, and helping all family members discover and remove the blocks to effective conversations.


CNA’s Nursing Innovation Exchange News article for English online and print newsletters Announcing the Nursing Innovations Exchange


The Quotable Nurse “You know you are having a bad day when you find a rectal thermometer behind your ear and realize some ass must have your pen.” Nurse’s Senility Prayer God grant me the senility to forget the patients I never liked. The good fortune to run into the patients I do like. And the eyesight to tell the difference! Advance Directives If I’m ever stuck on a respirator or a life-support system I definitely want to be unplugged. But not until I’m down to a size eight. Henriette Mantel, comedienne

FEATURE ARTICLES CREATING AN INTEREST IN GERONTOLOGY: A NURSING STUDENT’S EXPERIENCE Almir Alicelebic, BScN student, S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, [email protected] Veronique Boscart, RN, MScN, MEd, PhD(c), S. Bloomberg Faculty of Nursing, University of Toronto, 155 College Street, Toronto, Ontario, M5T 1P8, [email protected] Preparing new professionals to meet the acre needs of an expanding aging population is a continuous challenge. Not only are students’ experiences in gerontological care limited to initial practicums, but several studies found that students’ attitudes towards older people negatively changed throughout undergraduate programs. McKinlay & Cowan (2003) showed that nursing students had positive attitudes towards older people when entering their undergraduate programs, but these attitudes became less positive as they progressed through their educational modules. This attitudinal change is often caused by clinical experiences in under-resourced settings in which students often need to conform to routinized and depersonalized care. Pursey & Luker (1995) found that students frequently felt discouraged when they were unable to form meaningful therapeutic relationships with the people they care for. Due to the brevity of exposure and technical focus of clinical placements, students are rarely able to appreciate the complexity, challenges and rewards of geriatric care, and as a result, less of them seek gerontological careers upon graduation. A new approach to creating interest in gerontology is necessary to enhance recruitment of new professionals into the field of aging. One approach is to provide students with the possibilities to explore positive aspects of aging. Ryan et al. (2007) found that tutorial sessions on positive aspects of aging and visits to elders in the community improved nursing students' attitude from "undecided" to "positive". Furthermore, the exploration of older people's lived experiences enhances nursing students’ attitudes because it allows the formation of meaningful relationships. Through mentorship, 28 Vol. 26(1) www.cgna.net

additional clinical experience and exploration of related research topics, nursing students are able to connect with the elderly population and the gerontology career itself. We propose to implement mentored nursing student positions in gerontology as an adjunct to undergraduate modules. The goal of these positions is to provide the students with the opportunity to form close relationships with older people, a chance to apply theoretical knowledge in an actual clinical setting, and explore one’s own contributions to the meaning of positive aging. Over the past year, a University of Toronto nursing student had the opportunity to explore older people's life stories and needs, and to develop strong communication and relationship-building skills in such a mentorship position. By participating in a research study surveying elderly people, the student discovered that most of them praised the nurses who found the time to understand their needs, listen to their concerns, and appreciate their stories. The mentored position allowed the student to see the elderly person as an intriguing human being with his/her own unique needs. The position led to a raised awareness of how even ‘routinized care’ offers the opportunity to engage in mutual exploration of meaning and lived experiences. There is an urgent need for current gerontological education to shift from a focus on high priorities in acute and technical care to other aspects of care (Stevens & Crouch, 1998). Clinical preceptors and educators need to support students by presenting a balance of the lived experience exploration imbedded in the care practices. Mentored nursing student positions create an opportunity to explore gerontology beyond the technical and routinized approach of care for older people. The student valued the opportunity to appreciate older persons’ life stories and formed lasting therapeutic relationships. And it is exactly these aspects of nursing care that are the rewards of contributing to professional geriatric nursing. References Mc Kinlay A., & Cowan S. (2003). Student nurses’ attitudes towards working with older patients. Journal of Advanced Nursing, 43(3), 298-309. Pursey, A., & Luker, K. (1995). Attitudes and stereotypes: Nurses’ work with older people. Journal of Advanced Nursing, 22, 547-555. Ryan, A., Melby, V., & Mitchell, L. (2007). An evaluation of the effectiveness of an educational and experiential intervention on nursing students’ attitudes towards older people. International Journal of Older People Nursing, 2, 93-101. Stevens, J.A., Crouch, M. (1998). Frankenstein’s nurse! What are schools of nursing creating? Collegian, 5, 10–15.

NURSE SAY THE DARNDEST THINGS When I was a new nursing grad, I was working on a unit in long-term care that adjoined another unit. I was doing the 3 to 11 p.m. shift and it was about 10:45 when I saw a man wander over to my unit from the other unit. I carefully approached him and explained he was on the Whywrong Nurses Chose to need Worktowith Older Home unit and we go see hisPeople nurse. in HeNursing just looked at me BY funny, paused, and said, Hi. I’m Dr. Fisher.” Dr. Azza Hassan ([email protected]) - Nurse on the Net 29 Vol. 26(1) www.cgna.net

Why Nurses Choose to Work with Older People in a Nursing Home By Azza Hussan, RN, PhD ([email protected]) The world population is aging rapidly as a result of improved health care and greater control of infectious diseases.(1) According to the World Health Organization (WHO, 2002), the number of people aged 65 years and over was approximately 600 million in 2000 and is expected to reach 1.2 and 2 billion in 2025 and 2050 respectively.(2)The rapid increase in the aged population presents a challenge for health care professionals and particularly for RNs who comprise the major care provider group in the aged care sector.(1) Older people constitute the majority of users of healthcare services in all care settings. With the ageing of populations worldwide, community nurses in primary healthcare settings such as nursing homes have a key contribution to make to the health improvement agenda for older people, yet little is known of the extent of this aspect of their work. (3,4) Being older is associated with 'prolonged loss, poor health and dependency'. Ageing is viewed as a biomedical problem enabling a focus upon rehabilitation over cure and custodial care over prevention. Older people are treated as a group who have the same needs (essentialism), and who are seen as being separate from the mainstream (othering) and as belonging to another time (superannuating). In addition, these beliefs allow for the dehumanization older people making it easier to 'treat them with disrespect and devalue their experiences and desires.(5,6) Older people want to live in a home-like setting where they have autonomy over the daily routine--like meal times, bed times, and what activities to pursue. They want to choose when to take a shower or bath, and to decide whether to take a walk or read a book. They would prefer to stay at home rather than live in an institutionalized setting that focuses on care rather than daily life. They want to be surrounded by their own personal items, and they would rather that the person providing their care be a consistent presence who knows their preferences. (7) To meet these preferences will require a cultural transformation, a change in the perception of nursing homes from a place that is clinician-centered to one that is patient-centered. Nursing homes are now places that deliver long-term care, but they need to become places where people live and can also get good care. (5) Nursing homes provide a broad range of long-term care services – personal, social, and medical services designed to assist people who have functional or cognitive limitations in their ability to perform self-care and other activities necessary to live independently. Increasingly, nursing homes are also providing skilled nursing care, medical services, and therapies for short term, post-acute care following a hospitalization. (6) The role of RNs in the aged care sector and throughout the world is increasingly diversified as RNs are required to care for clients with complex needs and for those who are technology dependent. RNs in nursing homes are often expected to provide the same nursing interventions are those working in hospitals in order to meet residents’ needs. However, while nursing work in hospitals is seen as part of team work in nursing homes is considered more autonomous and therefore carries a great deal of responsibility (Valimaki & Leino-Kilpi, 2001). The nurse in four different types of role functions when working with older people within a rehabilitation ethos:


1. Supportive functions include; providing psychological support and emotional support, assisting with transition and life review, enhancing self-expression and ensuring cultural sensitivity. 2. Restorative functions are aimed at maximizing independence and functional ability, preventing further deterioration and/or disability, and enhancing quality of life. This is undertaken through a focus on rehabilitation that maxims the older person’s potential for independence, including assessment skills and undertaking essential care elements. 3. Educative functions involve the nurse teaching self-care (for example, self-medication and health promotion). In conjunction with other disciplines the nurse can facilitate a number of educational activities to increase confidence and competence in the activities of daily living. 4. Life enhancing functions include all activities aimed at enhancing the daily living experience and maximizing the independence of older people. This may include things such as reliving pain and ensuring adequate nutrition. (adapted from RCN, 2005) References 1. Lin CL (2007). The Roles and Working Experiences of Registered Nurses Working Experiences of Registered Working in Nursing Homes. Doctoral Thesis. Queensland University of Technology, Australia. 2. WHO. (2002). Active Aging: A Policy Framework. http://whqlibdoc.who.int/hq/2002/WHO_NMH_NPH_02.8.pdf 3. Lambrinou E, Sourtzi P, Kalokerinou A, and Lemonidou C (2009). Attitudes and Knowledge of Greek Nursing Students towards Older People. Nurse Education Today Accepted 26 January, Available online 24 February 2009. 4. Tyrrell A (2001). Nursing homes: a suitable alternative to hospital care for older people in the UK? Age and Ageing: British Geriatric Society, 30: 24-32 5. Evans A. What do baby boomers want? Changing the nursing home culture. www.snapforseniors.com. 6. Royal College of Nursing (2009). Maximizing Independence: The Role of the Nurse in Supporting the Rehabilitation of Older People, London: RCN RCNONLINE: www.rcn.org.uk/direct 7. AARP Public Policy Institute analysis of the 2007 National Nursing Home Survey (NNHS) and U.S. Census Bureau population estimates. 8. Valimaki M & Leino-Kilpi H (2001). The Role of CNSs in Promoting Elderly Patients’ Autonomy in Long-Term Care Institutions: Problems and Implications for Nursing Practice and Research. Clinical Nurse Speculum, 15 (1), 7-14. 9. Royal College of Nursing (2005) Nursing Homes: Nursing Values, London: RCN 31 Vol. 26(1) www.cgna.net

DANCE – MOVING THE BODY AND MIND By: Teija Ravelin, RN, D.H.Sc., Senior Lecturer Kajaani University of Applied Sciences P.O. Box 52 87101 Kajaani, Finland e-mail: [email protected] Dance has been defined in a nursing context as a resource of a human being learned from culture. Dance is a creative, unique but also universal phenomenon. Dance implies body movements, steps, body expression of one’s self, feelings and stories, and body interaction with one’s self and with others. Dance helps people to experience mental, physical, social and spiritual wholeness. (Ravelin, Kylmä & Korhonen, 2006.) Dance can be used in different ways in the care of older persons with dementia. We can arrange social dance events, creative dance and dance therapy sessions in care units. Watching a dance performance can be also an intervention in the care of elderly persons with dementia. According to many researches, dance is a nursing intervention which enhances elderly persons’ resources. Emotions and Interaction Social dance can evoke positive feelings and behaviour. It can also facilitate the positive interaction between nurses and elderly persons and give meaningful moments to be together. Furthermore, social dance can also activate an elderly person’s interest in the environment (Palo-Bengtsson 2000.) and be used in the treatment of depressed persons, because dancing can strengthen a positive self-image and activate (Haboush, Floyd, Caron, LaSota & Alvarez 2006). Also nurses have experienced dance as a useful mean of intervention (Palo-Bengtsson 2000). Dance/movement groups have been seen to have a favourable effect on language abilities of elderly persons with dementia. Their willingness to interact increased. (Hokkanen et al. 2003.) In dance therapy body movements substituted or supported speech as well as the ability to express thoughts, memories and emotions in Nyström’s and Lauritzen’s (2005) study. Creative dance affected positively social skills of the participants in a study by von Rossberg – Gempton’s, Dickinson’s and Poole’s (1999). There were two groups in the study: elderly persons who participated in an intergenerational creative dance program and children who participated in a creative dance class. The elderly were not demented. In this study all participants demonstrated cooperation, communication and sense of belonging: children also demonstrated an awareness of others. Dance performances based on elderly persons’ memories have been evaluated in the nursing home context as a process intervention having an effect on the elderly person and his/her interaction with others and also on the family members. Dance performance and its 32 Vol. 26(1) www.cgna.net

implementation as an intervention in the care of elderly persons with dementia has its own special features. According to this research, watching a dance performance is an active event to the demented elderly person. Feelings, memories and a sense of community with others aroused by dance performance are positively significant in the nursing care context. Dance performance is an interactive psychosocial intervention which promotes well-being and enhances the resources of the elderly person with dementia. (Ravelin, 2008.) Strength of the Dance Using dance in the care of elderly persons with dementia is essential, because dance can reach demented persons at a bodily and nonverbal level. Thus, dance can be a useful interaction method. References Haboush, B.A., Floyd, M., Caron, J., LaSota, M. & Alvarez, K. (2006). Ballroom dance lessons for geriatric depression: An exploratory study. The Arts in Psychotherapy, 33, 89– 97. Hokkanen, L., Rantala, L., Remes, A., Härkönen, B., Viramo, P. & Winblad, I. (2008). Dance/Movement therapeutic methods in management of dementia: a randomized, controlled study. Journal of the American Geriatrics Society, 56(4), 771-772. Nyström, K. & Lauritzen, S.O. (2005). Expressive bodies: demented persons’ communication in dance therapy context. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 9(3), 297–317. Palo-Bengtsson, L. (2000). Social dancing as a caregiver intervention in the care of persons with dementia. Dissertations from the Department of Clinical Neuroscience, Occupational Therapy and Elderly Care Research, Division of Geriatric Medicine and Centre of Elderly Care Research. Stockholm, Sweden: Karolinska Institutet. Ravelin, T., Kylmä, J. & Korhonen, T. (2006). Dance in mental health nursing: A hybrid concept analysis. Issues in Mental Health Nursing, 27(3), 307–317. Ravelin, T. (2008). Dance performance as an intervention in the care of elderly persons with dementia. Doctoral dissertation, Oulu, Finland: Faculty of Medicine, Institute of Health Sciences, Department of Nursing Science and Health Administration University of Oulu. Acta Universitatis Ouluensis. von Rossberg-Gempton, I.E., Dickinson, J. & Poole, G. (1999). Creative dance: Potentiality for enchancing social functioning in frail seniors and young children. The Arts in Psychotherapy 26(5): 313–327.


SUBMISSIONS FROM NURSING STUDENTS / NEW NURSING GRADUATES

REPORT ON THE KNOWLEDGE EXCHANGE INSTITUTE FOR GERIATRIC NURSING EDUCATION CONFERENCE Brock University, St. Catharines, Ontario, May 6-8, 2009 by Khaldoun Aldiabat PhD Nursing Student University of Calgary [email protected] This “Knowledge Exchange Institute for Geriatric Nursing Education” conference brought together a diverse group of participants made up of indigenous nursing leaders, academics, and Doctoral nursing students from different Canadian provinces, as well as Geriatric Nursing expertise from the United States. This conference has been sponsored by the “The Knowledge Exchange for Geriatric Nursing Education” which provides nursing faculty and doctoral nursing students with knowledge and tools to integrate best geriatric nursing knowledge and practices in their teaching and curricula using a train-the –trainer approach. The purpose of the conference was to afford a forum for discussion and brainstorming about gerontological nursing education in Canada building on the work of the Geriatric Nursing Education Consortium in the United States. However, the organizing committee and the participants also sought to move beyond conventional comparisons and committed themselves to the idea of extending, developing, and improving gerontological nursing education curriculum in Canada. In addition to receiving many Canadian and U.S. evidence based knowledge products and resources to use in their teaching, Doctoral nursing students and other educators cast new light on the common challenges that have been facing gerontological nursing education in Canada and brought many of the outstanding suggestions and solutions of these struggles into sharper focus. Different backgrounds and experiences of the conference attendants has contributed in determining the strategic options to improve gerontological nursing education, through including the elderly care courses in nursing undergrad curriculum.


By the end of the conference, the participants all agreed that an optimal plan to address nursing education in regard to the provision of high quality care for older adults must include both a dedicated course in gerontological nursing, and reinforcement of that learning through integrated content throughout the entire nursing baccalaureate curriculum. Therefore, participants went away with different creative plans to incorporate the resources in their institutions.

SHORT REPORTS REGARDING PRACTICAL MATTERS / INFORMATIVE WEBSITES

A new issue of Canadian Medical Association Journal has been made available: 26 May 2009; Vol. 180, No. 11 URL: http://www.cmaj.ca/content/vol180/issue11/?etoc

ENHANCING CREATIVITY IN OUR CARING PRACTICES

Cohen, G. (2009). New theories and research findings on the positive influence of music and art on health with ageing. Arts & Health: An International Journal for Research, Policy and Practice, 1 (1), 48-63 [This review is about the latest theories of the underlying mechanisms that explain why music and art promote health and have positive influences on the course of illness with ageing. Contact info for the author is as follows: Dr Gene Cohen (MD, PHD) The Center on Aging, Health & Humanities, The George Washington University Medical Center 10225 Montgomery Avenue Kensington, MD 20895 USA Email: [email protected] Website: http://www.gwumc.edu/cahh/About/cohen.htm Tel: (202) 895 0230


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