Title. Forgetfulness and older adults: concept analysis. Aim. This paper is a report of an analysis of the concept of forgetfulness as it applies to older adults. Background. Perceived increases in forgetfulness cause much distress for older adults due to the stigma associated with memory loss and dementia. The difference between forgetfulness in a healthy ageing state and memory loss associated with cognitive impairment requires clarification for nurses involved in screening and caring for older adults. Data sources. Literature for this concept analysis was obtained by searches of CINAHL, EMBASE and Internurse covering the years 1962-2009, as well as gerontology textbooks. Review methods. The evolutionary method of Rodgers was the framework for the concept analysis. Results. As we age there is a slight increase in occasions of forgetfulness (particularly remembering to do things in the near future) that can be offset by limiting distractions and enhancing focus. This is contrasted with forgetfulness patterns, also more likely as we age, that are indicative of disease processes. Older adults' awareness of their own forgetfulness has the potential to cause fear, embarrassment, anger and/or low self-esteem. Conclusion. It is important to avoid labelling or dismissal of concerns related to forgetfulness in older adults. Further research, with an emphasis on the choice of assessment tool, is recommended to investigate the benefits of nurse-led population screening for memory deficits in older adults. Nurses require training in assessment of memory and access to adequate referral pathways if abnormal results are uncovered.
This study results suggest that dependency in activities of daily living (an outcome of frailty) is strongly associated with a decreased likelihood of living alone and increased likelihood of referring oneself to community nursing services. Further research is necessary to examine how frailty screening in the referral process may enhance identification of older adults' community nursing needs in Dublin, Ireland.
Adverse Childhood Experiences (ACEs) research has demonstrated a strong correlation between a traumatic childhood and poor health and social status in adulthood. Maternal/child Public Health Nursing (PHN) home visiting teams frequently encounter families experiencing trauma, thus offering a unique opportunity to assist parents in recognizing the potential harm such stress may have for their child. The Sonoma County Field Nursing team developed a trauma‐informed model utilizing ACEs education in a self‐reflective approach with parents to increase family resilience and reduce the risk for future childhood trauma. This paper presents the supporting research used to develop the trauma‐informed approach and describes the execution of the model by the Sonoma County Field Nursing team.
This paper explores the current literature related to legal issues encountered by the public health nurse in Ireland in visiting clients exhibiting self-neglecting behavior. Nurses working in community settings where home visiting of clients is required will at some point encounter situations of client self-neglect. Possession of a clear legal framework for the local area that addresses both the nurse's professional responsibility and the client's rights is needed. Because a high incidence of depression and dementia seen in self-neglecting adults has prompted calls for wider screening of the agreeable client, an understanding of the definition of competence and capacity in the national legal system for that client becomes critical. In Ireland, as in many other countries, refusal of care or screening is the right of any competent adult. However, issues of mandatory reporting, confidentiality, and trespass may differ from other areas. Nursing care delivered at the community level to a client exhibiting self-neglecting behavior involves a delicate balance of trust and support. Through this overview of the legal implications for self-neglecting clients in Ireland, nurses have the opportunity to begin an exploration of similarities and differences in approach on a global level.
Traumatic experiences can have significant health effects, particularly when they are experienced during childhood. Structural determinants of health including environmental disasters and limited access to mental health services and affordable housing can contribute additional stress for parents with a personal history of childhood adversity. These factors can directly affect their children, contributing to intergenerational trauma. Pregnant people and families with young children are often referred to public health nursing maternal and child home visiting (HV) programs when there are concerns about historical or evolving childhood trauma. The strict eligibility and participation requirements of existing evidence-based maternal and child HV programs can exclude families that have experienced or are experiencing childhood trauma and its effects and can limit innovation by public health nurses, a hallmark of the field. Therefore, we advocate and describe the implementation of the Trauma Informed Approach in Public Health Nursing (TIA PHN) model, which incorporates a trauma-informed approach into a traditional maternal and child HV program in 3 California counties. TIA PHN, which began enrollment in March 2021, involves public health nurses and community health workers and integrates program evaluations in pursuit of evidence-based status. (Am J Public Health. 2022;112(S3):S298–S305. https://doi.org/10.2105/AJPH.2022.306737 )
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