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ABSTRACTObjectivesThis study aimed to examine the effect of 8-weeks of a 60-minute PARO intervention to reduce depressive symptoms and loneliness in older adults with dementia and investigated changes in their emotional or behavioral expressions and level of engagement with the PARO robot.MethodsThis was a quasi-experimental study with a repeated measures design. The outcome measures were evaluated at four time-points: before the intervention, week 4, immediately after the intervention, and one month after the PARO intervention.ResultsFifty-two participants were recruited. The age of the participants ranged from 65 to 96 years, with a mean age of 81.81 years (SD = 8.54) in the PARO group and 79.08 years (SD = 7.71) in the control group. Using a mixed between-within subjects’ analysis of variance, the results showed that there were significant interaction effects between the groups and time-periods for depression (p< .000), loneliness (p< .000), and engagement (p< .000).ConclusionsThe PARO intervention alleviated depression and loneliness for older adults. Furthermore, the process of engagement with PARO may play an important role in the PARO effects.Clinical ImplicationsA tailored PARO intervention of at least 4 weeks could engender positive psychological benefits for older adults.

The current study focuses on the short-term effect of MARIO, a social robot, on quality of life, depression, and perceived social support in persons with dementia (PWD) and evaluates their acceptability of MARIO. Ten PWD in one nursing home took part in a 4-week pilot study, where each participant had up to 12 sessions with MARIO. Sessions comprised engagement in music, news, reminiscence, games, and calendar applications. Standardized questionnaires were administered before and after the 4-week period. Participants had a sustained interest in MARIO during their interactions and an acceptance of MARIO's appearance, sound, and applications. Consequently, participants spent more time socially engaged. No statistically significant differences were found in quality of life, depression, and perceived social support. PWD can engage with a social robot in a real-world nursing home. Future research should incorporate a larger sample and longer intervention period. [Journal of Gerontological Nursing, 45(7), 36–45.], Dementia is a major individual, societal, and economic challenge. With rising trends in life expectancy, the number of persons with dementia (PWD) is expected to more than triple to 152 [...]

Nurses are the largest group of registered healthcare professionals and are fundamental to delivering health and aged care in Australia.

Nursing students encounter older people in all health care sectors; however, few choose a career primarily focused on older person's care.

Meeting the complex health needs of an increasing number of older people is a critical workforce challenge for the Australian health and aged care sectors. Nurses are the largest group of registered health care professionals and fundamental to delivering health and aged care in Australia. However, while nursing students encounter increasing numbers of older people in all health and aged care settings, little is known about how they are educationally prepared to care for them.

Background: There is a paucity of evidence on the efficacy of garden design based on dementia-friendly environment (DFE) characteristics on the level of agitation, apathy, and engagement of people with dementia in residential aged care facilities (RACFs).Objective: To investigate the effect of a garden improved according to DFE characteristics on agitation, apathy, and engagement of people with dementia in one RACF.Methods: A case study design with a mixed-method approach was used.Results: There was no significant improvement in the level of participants’ agitation following visits to the improved garden, χ2(2) = 5.167, p= .076. A high level of engagement was found in participants during the intervention (Week 1-1, p< .01; Week 1-2, p< .01; Week 2, p< .01; Week 3, p< .05; and Week 4, p< .05) when compared to before intervention (Week 0). A higher level of apathy was found in participants at Week 0 when compared to during the intervention (Week 1-1, p< .05; Week 1-2, p< .01; Week 2, p< .05; Week 3, p< .01; and Week 4, p< .01). Five themes emerged from participant interviews: the presence of sensory-provoking elements in the garden, meaningful engagement in the garden, accessibility of the garden, garden impacts, and garden experiences that demonstrated the effectiveness of the garden.Conclusions: The garden promoted engagement and decreased apathy of people with dementia living in the RACF with the researcher’s partial facilitation of the intervention sessions. The qualitative findings indicated the effectiveness of the garden in reducing agitation.

The aim of this study was to investigate the feasibility and preliminary efficacy of a modified mindfulness-based stress reduction (MBSR) program and mindfulness-based cognitive therapy (MBCT) program for reducing the stress, depressive symptoms, and subjective burden of family caregivers of people with dementia (PWD).

Family carers of people with dementia face different challenges in providing care for daily living activities of their care recipients. Today, mHealth applications are widely used in healthcare.

This study aims to describe a protocol to develop a conceptual design for a technological device based on theoretical knowledge to improve medication adherence in people with dementia. The six steps of the intervention mapping approach will be systematically applied. Step 1 will be a needs assessment using a mixed‐methods approach: a survey and interviews with carers to identify determinants of medication non‐adherence. Device outcomes and objectives will be set in Step 2 followed by the selection of practical theory‐informed methods in Step 3. In Step 4, the structure of the conceptual design will be determined through a Delphi technique. Finally, the implementation and evaluation plans for the design will be developed in Steps 5 and 6. To improve medication adherence in this population, the design should address the condition, patients’ and caregivers’ needs and factors contributing to the problem. Involvement of end‐users and a multidisciplinary team will ensure a practical and fit‐for‐purpose design bridging the gap between research and practice.

Improving perception of gerotranscendence can increase life satisfaction in older adults to achieve successful aging. The purpose of this study was to evaluate the feasibility and effect of a multidimensional support program (MSP) on gerotranscendence and depression in community-dwelling older adults. Using a cluster–randomized control trial design, four sites (98 participants) were randomly assigned to a MSP or control group. The Gerotranscendence Scale and Geriatric Depression Scale were administered pre- and postintervention. A total of 91 participants completed the study. The mean attendance rates in the MSP and control groups were 85.5% and 84.3%, respectively. The MSP was found to significantly enhance the perception of gerotranscendence in older adults but not their level of depression. This study demonstrated the MSP is a feasible and effective program to improve perception of gerotranscendence and may potentially lead to positive psychological well-being for older adults.[Res Gerontol Nurs. 2019; 12(3):148–158.]

The progressive and complex nature of dementia demands carers have specific knowledge and training. However, often carers do not have adequate knowledge and skills, particularly for functional disability care.

Prolonged sitting time has been reported among university workers which can have adverse health effects. The aim of this study was to examine the sitting time, physical activity, and psychological well-being reported by older university office workers. An online self-reported survey was distributed to all office workers 55 years and older at one university in Australia. Sixty-six office workers were recruited. They reported an average sitting time of 7.5 hours per day on weekdays. In all, 72.7% of the sample reported both moderate and high physical activity levels. A high percentage of the office workers reported depression (25.8%) and anxiety (12.1%). Lower education levels were significantly related to higher perceived stress and more depressive symptomatology (p= .03 and .02, respectively). Significant associations were found between stress, depression, and anxiety (p< .001) among this group of workers.

The current study aimed to describe the effect of an educational program on RN-initiated efforts to involve family caregivers in delirium care. A descriptive qualitative study was performed. A purposive sample of 12 RNs who participated in a one group, pre–post evaluation of a delirium educational program, and a nominated sample of six family caregivers of patients who had been cared for by RNs in the program participated in individual, in-depth interviews. The qualitative findings indicated that the inclusion of a delirium brochure in ward orientation on admission, with reinforcement during shift changes, and RN-initiated engagement with family caregivers promoted family caregiver involvement in delirium prevention. Further studies in South Korea are needed to determine which family-centered nursing care interventions are culturally appropriate and most effective for RNs and family caregivers in delirium care. [The current study aimed to describe the effect of an educational program on RN-initiated efforts to involve family caregivers in delirium care. A descriptive qualitative study was performed. A purposive sample of 12 RNs who participated in a one group, pre–post evaluation of a delirium educational program, and a nominated sample of six family caregivers of patients who had been cared for by RNs in the program participated in individual, in-depth interviews. The qualitative findings indicated that the inclusion of a delirium brochure in ward orientation on admission, with reinforcement during shift changes, and RN-initiated engagement with family caregivers promoted family caregiver involvement in delirium prevention. Further studies in South Korea are needed to determine which family-centered nursing care interventions are culturally appropriate and most effective for RNs and family caregivers in delirium care. [Journal of Gerontological Nursing, 43(12), 44–51.]

Background: Neuropsychiatric symptoms of dementia are often treated through the prescription of one or more psychotropic medications. However, limited efficacy and potential harmful side-effects has resulted in efforts to reduce the use of psychotropic medication in this population, particularly for those living in long-term care. Objectives: This study sought to describe the pattern of central nervous system medication usage in older adults with dementia living in long-term care; assess the appropriateness of prescribing against Beers criteria; and detect potential drug interactions from co-administered medications. Methods: A retrospective descriptive audit of the medical records of n=415 residents, aged >60 years with a diagnosis of dementia, from 28 long-term care facilities in Queensland, Australia. Information extracted included the types and usage of regular and Pro Re Nata central nervous system medications. Results: Of those taking medication (n=317), 68% were prescribed at least one potentially inappropriate medication, and there was a significant positive correlation between the number of medications prescribed and the number of potentially inappropriate medications. Two-hundred potential interactions with variable severity were identified from 130 residents on ≥1 medication – 38% were potentially severe interactions, 46% were moderate. Conclusion: This medication audit raises concerns that prescription of medications may still be the first resort to treat behavioural and psychological symptoms of dementia. There is a need for effective and sustainable person-centred interventions that address barriers for appropriate prescribing practice, and involve the collaboration of all healthcare professionals to optimise prescribing and improve the quality of medicines in older people with dementia.

In the absence of a cure for dementia, there is an increasing recognition of the need to develop approaches that address its key impacts of social isolation, depressed mood, and quality of life. In response to these issues, a three-year research project entitled Playful Engagement and Dementia: assessing the efficacy of applied theatre practices for people with dementia in residential aged care facilitieswas developed in partnership with Wesley Mission Brisbane. The paper reports on data collected within the pilot phase of this project, offering an analysis of the play vocabularies used by two applied theatre artists who interacted, using a relational clowning approach, with 17 residents with mid- to late-stage dementia. The analysis, based on two complementary frameworks, reveals useful insights into the key features of the approach, noting those that were effective in generating ‘moments’ of engagement and mutual recognition. How the applied theatre artists spontaneously, reflexively, and sensitively applied these vocabularies, tailoring them to each individual's play preferences, interests, and stage of dementia is also examined.

This pilot study aimed to compare the effect of companion robots (PARO) to participation in an interactive reading group on emotions in people living with moderate to severe dementia in a residential care setting. A randomized crossover design, with PARO and reading control groups, was used. Eighteen residents with mid- to late-stage dementia from one aged care facility in Queensland, Australia, were recruited. Participants were assessed three times using the Quality of Life in Alzheimer’s Disease, Rating Anxiety in Dementia, Apathy Evaluation, Geriatric Depression, and Revised Algase Wandering Scales. PARO had a moderate to large positive influence on participants’ quality of life compared to the reading group. The PARO intervention group had higher pleasure scores when compared to the reading group. Findings suggest PARO may be useful as a treatment option for people with dementia; however, the need for a larger trial was identified.

To present clinical findings and etiologic investigation of two consecutive clusters of toxic anterior segment syndrome (TASS) after uncomplicated phacoemulsification cataract surgery.

To describe the impact of living in a nursing home on quality of life (QoL) in people living with dementia.

There are thousands of parasitic nematode species that have been identified. Many have been documented to invade the eye and periorbital tissues. Whether adult or larvae, alive or dead, they can result in a wide range of ocular and systemic manifestations. Classification of the nematode can be helpful in the treatment planning for these patients.

AbstractSo-called diseases of affluence, otherwise known as ‘lifestyle diseases’, are attributed to modifiable risk factors that are influenced by lifestyle and personal behaviour. Leading by example is an important way for public health principles to be communicated. In the university context, students of nursing can become aware of the challenge to integrate and apply health principles in their own life so that they become responsible health leaders in the community. The aim of this study was to explore the incidence of a number of behaviour-associated health risk factors within a group of undergraduate nursing students. Ninety-four students participated in the study. Seventy-seven students (82%) reported the presence of at least one modifiable health risk factor. Forty-four percent of respondents were either overweight or obese. Further research to explore whether a health promoting curriculum encourages nursing students to internalise/apply health knowledge to their own lives is recommended. A campaign of public health might be useful within the university community to educate students about risk factors and healthy living.

AbstractHealth care staff knowledge of mental health is vital in the provision of quality care for older people in residential aged care settings. This paper aims to describe mental health knowledge competence of health care staff in residential aged care through a review of existing literature and to explore the link between knowledge, attitudes and education about older people and mental health.A literature review was conducted using electronic databases and library catalogues to identify articles published in English during the period 1982–2002.There is insufficient evidence within the literature to draw conclusions about staff knowledge levels in relation to mental health, however, the literature identified a link between continuing education, knowledge levels and staff attitudes to older people with mental health disorders. Future studies are needed to investigate existing levels of mental health knowledge among health care staff in residential aged care and to identify and evaluate strategies to enhance their ability to provide care for this population.

Staff awareness and compliance with infection control (IC) policies and procedures is vital to achieve practice standards and minimise the risk of infection. This paper examines aspects of an existing IC programme in a long-term aged care setting from the perspective of health care staff. An anonymous survey of staff produced a response rate of 30% (n = 199). The majority of respondents (98%) were aware of an IC manual in their workplace, but nearly a quarter (23.1%) reported never using the manual. There was a moderately high level of compliance with the application of IC principles in 10 work care events (mean score 39.7 out of 50, SD = 2.3, range 30-45) but a higher level was expected. There was no statistical difference between occupational groups in terms of compliance. Over 50% of the sample reported that only minor change was required to improve their IC work practices. Nearly 60% reported that nothing prevented them from improving their work practices, but 37% felt they were hindered in making changes. In terms of surveillance, respondents "always" collected data on urinary {77.7%), respiratory (65.3%) and gastrointestinal (60.8%) tract infections, skin (67.8%) and wound (71.9%) infections. Organisations need to provide ongoing staff education to enhance knowledge and compliance with procedures, and minimise barriers to effective IC practices.

Background:childbirth generates powerful emotions and may lead to the development of symptoms of depression, anxiety, and trauma in some women. Debriefing and non-directive counselling have been used as early interventions to reduce the prevalence of depression and post-traumatic stress.

In July 2000 a statewide infection control survey was mailed out to 483 long-term care facilities (LTCFs) in Queensland, Australia. The survey aimed to identify the presence and composition of infection control programmes in LTCFs and to investigate their relationship to the process elements of infection control programmes. A response rate of 43 per cent (n = 206) was achieved. The survey found that almost all LTCFs (97 per cent) had an infection control programme in place. A majority (70 per cent) had an infection control committee or another committee with responsibility for infection control. The time allocated to infection control was only 1-2 hours per week in the majority (56 per cent) of facilities, and there was no correlation between this time allocation and bed numbers. Almost all (99 per cent) facilities provided infection control education to their staff. Most facilities conducted surveillance for urinary tract infection, respiratory tract infection or wound and skin infection. Surveillance data was used for staff feedback, education and/or accreditation in 95 per cent of facilities. Further investigation is warranted in order to identify the amount of time required to fulfil infection control responsibilities in LTCFs. This study also suggests that minimum standard definitions for surveillance are required for the LTCF in order to facilitate data collection and analysis, benchmarking ability and possible aggregation of information.

According to overseas studies, there is a high rate of infection in aged care facilities, but little is known about the causes of infection in the Australian context. Demographic data indicate that the elderly occupy an increasing proportion of the total population and there is increasing demand for aged care facilities. There is therefore an important need to address issues related to the development of infections in the institutionalised aged, a population particularly vulnerable to infection by virtue of the many physiological changes and other factors associated with the aging process. Through a review of the literature, this paper provides an overview of factors that influence the likelihood of health care associated infections in the institutionalised aged, and outlines practical strategies for the prevention and control of infection. The review highlights the need for further research and recommends attention to funding and staffing levels, formation of infection control committees, implementation of surveillance programmes, development of policies and procedures and ongoing staff education.

AbstractThe emergence of community-based primary health care programs is considered to be one way of improving the health of the community, including the older population. While community-based programs are considered to provide worthwhile resources to a range of individuals, regular evaluation of these services is required to ensure the services are meeting the needs of the community. This paper discusses ‘The 60 and Better Program’ as a means of improving the health of the older population. It is argued that as the program aims to empower the older population and to promote equity and access, the program is meeting the major principles of primary health care, and thus working towards improving and maintaining the health of the target group of the older population. It is further argued that the nurse has a major role in encouraging older members of our community to become active in programs such as ‘The 60 and Better Program’.

The article focuses on the study conducted to examine the effect of foot massage on agitated behaviors in patients with dementia. According to a caregiver report, the most common agitated behaviors observed in patients, were verbal aggression, and wandering movements. Further it concludes that foot massage plays an effective role in decreasing the agitation in patients with dementia.