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Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Studying nursing interventions in acutely ill, cognitively impaired older adults
Kathleen McCauley1, Christine Bradway, Karen B Hirschman
1Kathleen McCauley is associate dean for academic programs, the Class of 1965 Reunion Term Professor of Cardiovascular Nursing, and a member of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, Philadelphia, where Christine Bradway is a member of the Center for Integrative Science in Aging and an associate professor of gerontological nursing, Karen B. Hirschman is a research associate professor and member of the NewCourtland Center for Transitions and Health, and Mary D. Naylor is the Marian S. Ware Professor in Gerontology and the director of the NewCourtland Center for Transitions and Health. All authors are members of the Department of Biobehavioral Health Sciences at the University of Pennsylvania School of Nursing. The authors received support from the National Institute of Aging (R01AG023116) and the Marian S. Ware Alzheimer Disease Program at the University of Pennsylvania. Contact author: Kathleen McCauley, kmccaule@nursing.upenn.edu. The authors have disclosed no potential conflicts of interest, financial or otherwise.
Overview:
Although it increases the risk of poor outcomes and raises the costs of care, cognitive impairment in hospitalized older adults is often neither accurately identified nor well managed. In conducting a two-phase, comparative-effectiveness clinical trial of the effects of three nursing interventions-augmented standard care, resource nurse care, and the transitional care model-on hospitalized older adults with cognitive deficits, a team of researchers encountered several challenges. For example, in assessing potential subjects for the study, they found that nearly half of those assessed had cognitive impairment, yet many family caregivers could not be identified or had no interest in participating in the study. One lesson the researchers learned was that research involving cognitively impaired older adults must actively engage clinicians, patients, and family caregivers, as well as address the complex process of managing postdischarge care.
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