There is a growing population of those with dementia and other cognitive impairments that affect the quality of life. This is attributed to advances in science, technology and medicine leading to reductions in maternal mortality, infectious and parasitic diseases, occupational safety measures, and improvements in nutrition and education of the global population. According to the Administration on Aging (AoA), an agency of the U.S. Department of Health and Human Services in 2000, approximately 605 million people were 60 years or older. By 2050, that number is expected to be close to 2 billion. Animal assisted therapy (AAT) has been used as a therapeutic activity among the elderly to help improve well being and quality of life, but there has been limited research to demonstrate its effectiveness among those with dementia. The purpose of this study was to compare the effectiveness of AAT versus human interaction only on social behaviors and engagement among elderly patients with dementia in long-term care facility. Following random assignment to groups, the participants experienced two visits per week over a two-week time period of either animal therapy visits or human interaction visits. One week with no activities then followed then with alternate animal therapy and human interaction visits. The human interaction visits consisted of conversation and reading from and looking at pictures in a newspaper. During animal visits, participants were encouraged to touch, pet, brush, and talk to the dogs. In this study, AAT increased positive social behaviors resulting in fewer incidents requiring staff intervention. AAT coincides with current goals in long-term care settings -improving and enhancing socialization behaviors among older adults with dementia.

In many everyday situations, individuals with mental illness face stigma that leads to discrimination. A growing body of evidence suggests that those with mental illness experience disparities in health care and that their medical needs are often overlooked. The purpose of this article is to increase awareness to this problem. Fictional vignettes in which individuals with mental illness seek medical care are presented, followed by discussion on the role discrimination may play in the level of care these patients received. To help alleviate disparities, nurses are encouraged to advocate and speak out when they suspect discrimination is affecting the quality of care of those with mental illness.

Animal-assisted activities (AAAs) show promise in providing emotional and social benefits to older adults and may be used as a tool to promote therapeutic communication between students and cognitively impaired older adults. The purpose was to develop a program incorporating AAAs to enhance social engagement of cognitively impaired older adults in a community respite program and in turn enhance student comfort when caring for this vulnerable population. The Dementia Attitudes Scale, a validated tool, was used to measure students' attitudes before and after AAA intervention. Data were analyzed using repeated-measures analysis of variance. Students were significantly more comfortable and demonstrated a gain in knowledge after AAAs were included in the community clinical experience. Incorporating AAAs into student community/service-learning clinical experience improved communication between students and cognitively impaired older adults, improving students' attitudes when caring for this population.

Maintaining academic integrity is a universal problem and can be especially difficult when implementing a simulation scenario that must take place over several days. It became obvious to faculty that students scheduled in later sessions exceeded realistic expectations in their performances. In response to this, faculty created two scenarios (one psychiatric and one medical-surgical)with flexibility that provided each student a unique and challenging learning experience while guiding the facilitator along various pathways based on the student's actions in the scenario. This allowed the overall learning objectives to be maintained regardless of students sharing information from simulations scheduled on earlier dates. Adapting the scenario based on individual student's responses allowed each student to have a unique learning opportunity in spite of the students being "prepped" by students that had already participated in the simulation. Faculty and student feedback revealed the flexibility of the scenarios was a valuable and meaningful learning experience. This paper discusses how to plan and implement this innovative approach to simulation, which will help to counter the effects of information sharing among students.

Cognitively impaired older adults pose challenges that include communication barriers that may contribute to social isolation of the individual and frustration by both the individual and caregivers. Healthcare professionals must to be prepared to speak to the distinctive requirements of this population. Innovative strategies are needed to improve the ability of caregivers and health professionals to establish effective communication. Animal Assisted Therapy (AAT) is a complementary therapy that shows promise in providing emotional and social benefits to older adults in both clinical and community settings. This project aims to describe the benefits of incorporating AAT within a community respite program to enhance social engagement of cognitively impaired adults. In this project a group of subjects were exposed to two situations in an unsystematic order, visits with a dog and visits without a dog. The purpose was to compare each visit and its effect in improving engagement in those attending a community respite program. Throughout the study, respite attendees were encouraged to engage with dogs or the human visitor. In this study, AAT enhanced social engagement.