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Gilmour, J. A. (2001). On the margins: Nurses and the intermittent care of people with dementia: A discourse analysis. Ph.D. thesis, , .
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Dulieu, F. (2005). Collaborative practice: A study in bridging the gap to transform the delivery of specialist palliative nursing care in residential aged care facilities.
Abstract: This paper documents a practice development initiative with the aim of formulating a rationale for the professional practice development of a relatively recently conceived nursing initiative; that of a Palliative Care Liaison Nurse (PCLN) role. The project involved conducting an inquiry through a search of the literature with the aim of discovering ways to articulate, then develop, the role to meet the needs of elderly people living in Residential Aged Care Facilities (RACFs), their family and the whanau. The paper initially explores the concept of liaison roles globally, to consider how this role might be located as an interagency position between palliative care and aged care within the context of Aotearoa/New Zealand. The paper then reveals the perceived skills and personal attributes required by a person in the PCLN role that the author, drawing from personal and professional experience of having been appointed to this position, considers are necessary to effectively manage the diverse dimensions of this role. Bridging the gap is a key role discussed which centres on the capacity to organise and present an effective education programme while supporting, encouraging and role modeling for staff providing the day to day nursing care. This role involves practice wisdom and advocating for change and tolerance within everyday practice. An example of this dimension is discussed in depth, because the researcher considers that through staff working together, they can effectively bridge the knowledge-practice gap which exists between specialist palliative and gerontological nursing care.
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Meldrum, L. B. B. (2006). Navigating the final journey: Dying in residential aged care in Aotearoa New Zealand.
Abstract: New Zealand statistics project that the aging population of people aged 65 years and over will more than double in the next decade. This has implications for palliative care providers including hospices and hospitals because long-term inpatient care is not generally provided by hospitals and hospices. When dying patients need long-term care, residential settings become an option. The level of palliative care in these facilities is dependent on staff training and numbers. In general, staff are not trained in palliative care, neither do they provide the multidisciplinary facets that define palliative care as undertaken by hospices. This paper describes a practice development initiative using storytelling as the vehicle for introducing the concept of the Liverpool Care Pathway (LCP) for the dying patient into residential aged care settings. With the emergence of a reflective paradigm in nursing the concept of storytelling as a teaching/learning tool has grown. Many staff in residential care settings come from diverse ethnic backgrounds where for some, English is their second language. Storytelling therefore can be a useful approach for learning because it can increase their communication skills. The author suggests that the Liverpool Care Pathway for the dying patient is a model that can be translated across care settings, hospice, hospital, and community. It can demonstrate a framework that facilitates multiprofessional communication and documentation and embraces local needs, culture and language to empower health care workers to deliver high quality care to dying patients and their family/whanau and carers. This paper also explores the role of a facilitator as an agent of change and discusses how the interplay of evidence, context and facilitation can result in the successful implementation of the LCP into residential aged care settings.
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Kupa, S. (2006). Psychogeriatric nursing: A review of the literature.
Abstract: This paper is a literature review of the psychogeriatric specialty and describes the clinical role, practice and knowledge of the psychogeriatric nurse. Literature reviews provide a useful means for evaluating what is currently known and understood in a particular area of interest to help nurses' build current opinion into practice. Psychogeriatric nursing is a specialised field of practice that focuses on the mental health needs of people over the age of 65 (including younger people who have acquired needs that are similar in 'like' and age and 'interest'). The literature asserts the urgent need to develop the role and practice of the psychogeriatric nurse in order to address the complex needs of our ageing population in areas such as home care, hospitals, primary health, and long term care institutions. The findings highlight aspects of nursing care that are essential to the role and practice of the psychogeriatric nurse. Knowledge that is necessary for best practice in psychogeriatric nursing care is drawn mainly from the field of general psychiatry and gerontology but also from general medicine, psychology, neurology, and disability. Nurses' working with older adults affected by psychogeriatric conditions must possess a broad knowledge of physical and mental health issues that affect the elderly, including also knowledge and understanding of psychosocial risk factors that can also have an impact on the health and behaviour of older people and their carers. Despite these literal assertions however there appears to be a dearth of literature available to support the requirements for developing the psychogeriatric nursing specialty in clinical practice, research, and education. The author notes that authorities in this specialised field of practice generally agree that with an increasing aging population looming in the future more research in the field of “old age psychiatry” will be critical.
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Ward, V. C. (2013). Preoperative fluid management of the older adult patient with hip fracture. Master's thesis, Victoria University of Wellington, Wellington, NZ.
Abstract: Explores the relationships between pre-operative fluid management (PFM) and post-operative outcomes. Undertakes an observational study of 100 consecutive older adult patients admitted to a tertiary NZ hospital with traumatic hip fracture between March and Sept 2012. Gathers data regarding cohort demographics and in-hospital events, including surgical details, alongside PFM and post-operative outcomes. Itemises characteristics of the patients, predominantly female with a mean age of 85.2 years. Finds no statistically significant relationship between pre-operative fluid management and post-operative outcomes.
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Rodgers, V., & Neville, S. J. (2007). Personal autonomy for older people living in residential care: An overview. Nursing Praxis in New Zealand, 23(1), 29–36.
Abstract: This article looks at the concept of autonomy particularly in relation to the population of older persons living in residential care settings. It examines the values underpinning the exercise of personal autonomy and notes how individual autonomy may be enhanced or restricted. The implications for gerontological nursing practice are outlined and suggestions offered as to how personal autonomy for older persons living in residential care may be preserved and promoted.
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King, A., & Parsons, M. (2005). An evaluation of two respite models for older people and their informal caregivers. Access is free to articles older than 6 months, and abstracts., 118(1214).
Abstract: The researchers evaluate two case-management models of respite relief care at Waitemata District Health Board. The evaluation consisted of semi-structured interviews and postal surveys for clients utilising respite care and staff members involved in both the North/West and Rodney models of respite care in Auckland. Across the two regions, a total of 2 older people and their informal caregivers, 2 respite coordinators, and the Needs Assessment Service Coordination (NASC) Manager were interviewed. In addition, postal surveys were received from 21 older people, 36 informal caregivers, 11 NASC workers, and 3 allied health professionals. Findings revealed there was generally high satisfaction with both the respite models. Caregivers believed the respite service did give them a break, although it was insufficient. Caregivers reported concerns regarding how respite facilities could improve and the older person's deterioration post respite. Staff identified improvements for each of the models.
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Davy, R. (2002). Strategy to increase smear testing of older women. Practice nurse: Official Journal of the New Zealand College of Practice Nurses, 2(3), 13–14.
Abstract: The author presents a project to increase enrolments of women aged 60-69 years in the cervical screening programme. The programme included provision of packages comprising fliers, counter signs, stickers, postcards and pens to 1387 women's groups or locations where women gather. The author collates and analyses calls to the advertised 0800 telephone number, smear tests at the Well Women's Nursing Trust, and enrolment rates on the Cervical Screening Register from June to August 2001.
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Neville, S. J., & Alpass, F. (1999). Factors influencing health and well-being in the older adult. Nursing Praxis in New Zealand, 14(3), 36–45.
Abstract: This article offers a literature review of selected factors influencing the health and well-being of older people, with a particular emphasis on the older male. Implications for nursing practice in New Zealand are discussed.
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Walsh, K., McAllister, M., Morgan, A., & Thornhill, J. (2004). Motivating change: Using motivational interviewing in practice development. Practice Development in Health Care, 3(2), 92–100.
Abstract: The present paper draws on experiences and insights gained by a group of psychiatric nurse practice development facilitators whilst working with consumers, carers, clinicians and managers in the context of a practice development programme in a large metropolitan psychiatric hospital. The paper describes how the practice development facilitators were able to adapt techniques of motivational interviewing, commonly used in drug and alcohol treatment services, to help motivate change in an aged care setting. The lessons embedded within this experience are that people do want change, and that sustained change requires ownership and support. Practice development facilitators can assist in this process though the use of principles and strategies of motivational interviewing, which include increasing awareness of the need for change, supporting self-efficacy and managing resistance to change.
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Bland, M. F. (2005). The challenge of feeling 'at home' in residential aged care in New Zealand. Nursing Praxis in New Zealand, 21(3), 4–12.
Abstract: In this research report, a resident reveals the challenges associated with firstly becoming a nursing home resident, and then trying to establish a new sense of 'home'. The story supports a conclusion that nurses' knowledge of the unique 'admission story' of each resident, and their individual understandings of home, is essential in promoting their ongoing comfort. Although approximately 30,000 older adults live in residential aged care, little research has been done on their experience.
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Mears, A. (2003). The role of the clinical nurse co-ordinator. Journal of the Australasian Rehabilitation Nurses Association, 6(3), 24–25.
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Challis-Morrison, S. (2006). Caring for a community wanderer. Kai Tiaki: Nursing New Zealand, 12(11), 20–22.
Abstract: A community based registered nurse from Waikato District Health Board's Older Persons Assessment Team (OPAT) presents her experiences of working with older people with dementia. She uses a case study approach to highlight the issue of wandering, behaviour which can be difficult to modify and can cause carer distress. She outlines a team approach to the condition which requires good communication and co-ordination. Key aspects of management included a risk assessment plan, support for caregivers, and encouraging activity.
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Neville, S. J., & Gilmour, J. A. (2007). Differentiating between delirium and dementia. Kai Tiaki: Nursing New Zealand, 13(9), 22–25.
Abstract: Accurate nursing assessment is a critical element in the identification of health problems and treatment strategies for older adults who have delirium and/or dementia. This practice update provides information on the differentiation between these two debilitating and adverse health events, along with some useful assessment frameworks and other resources. Comments from people with delirium and dementia are interspersed throughout the article to draw attention to the impact of these conditions on people's lives and well-being. The article includes the 'A presenting concern framework', useful mnemonic devices to help nurses assess an older person who may have delirium or dementia, and a list of online resources.
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Fail, A. (1999). Ageing in the 21st century. Vision: A Journal of Nursing, 5(9), 24–31.
Abstract: The author looks at demographic and statistical information to extrapolate on trends that will affect the aged through into to the next century. She reviews policy approaches to the issues of a growing aged population combined with social and economic changes that could make this group vulnerable. Effective planning for the provision of quality care is placed in the context of social changes, advances in gerontology, and social theories of ageing.
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