aging Archives - Off the Charts

‘I Didn’t Think It Would Happen to Me’

A daughter notices cognitive changes in her mother, a former geriatrics nurse.

Illustration by Janet Hamlin for AJN.

This month’s Reflections essay, “In Full Bloom,” is a gentle, humane exploration of what it’s like when an aging parent shows signs of cognitive decline. Author Diane Fraser deftly weaves memory, incident, and reflection together in this bittersweet one-page essay.

She describes her mother’s dawning realization of the hard reality of her own aging. “I’m old,” she said. “I’m really old.”

And then later, perhaps also alluding to her worsening dementia:

“I didn’t think it would happen to me. . . Those were my patients. This is me.”

There’s a family birthday party. An annual visit to a lilac festival where the author begins to find certain aspects of her mother’s behavior puzzling.

This is all described with lightness and respect. It’s just how it is, the author seems to suggest. We might as well make the best of it.

She remembers the sometimes bawdy stories her […]

Jacob Molyneux, senior editor/blog editor2021-11-01T10:19:57-04:00November 1st, 2021|Nursing|0 Comments

‘Worth Its Weight in Gold’: The Small, Unexpected Triumphs of Nursing

“Nursing is a job that sometimes finds you investing emotionally in things you never expected to care about.”

How many times have you waxed enthusiastic at work about something that people who aren’t nurses would find weird, or even downright gross? Eyeing a patient’s Foley bag and exclaiming about how great her urine looks…praising a young man for coughing up gobs of sticky sputum….

Illustration by Pat Kinsella for AJN.

The challenge of obtaining a specimen.

In this month’s Reflections column, “Worth its Weight in Gold” (free until July 7), visiting nurse Jonathan Robb describes his efforts to obtain a urine sample for culture from an elderly woman who has minimal bladder control.

Most of us are familiar with the balancing act of obtaining a specimen under conditions that cause discomfort or embarrassment to a patient. We cajole and gently press for whatever has to be done, trying to maintain a relaxed atmosphere while hiding any urgency about completing the task that we might feel. This delicate pas de deux has the potential to be very stressful for both parties.

Robb’s sometimes comical descriptions of the contortions necessary to meet his particular challenge will ring true to nurses.

“…despite the fact […]

Share this:
Facebook
Bluesky
X
LinkedIn

Betsy Todd, MPH, RN2019-06-17T10:16:20-04:00June 17th, 2019|Nursing, nursing stories, patient engagement|0 Comments

Mild Cognitive Decline or Physical Limitations: What’s a Nurse to Do?

Noticing small changes in what’s possible.

I worked for many years in infection prevention and control, and loved it. Still do. But I loved bedside work too, and it was always in the back of my mind that I might one day return to staff work. That is, until I took care of a family member during the last year of his life.

While I think I provided him with reasonably good care—let’s not get into the emotional connection that made me a less objective caregiver than were his fantastic CNAs—there was no fooling myself any longer. After years away from the bedside, my assessment skills have slipped. I’m not used to working while wearing glasses (without which I can’t read labels or check for reddened skin or cloudy urine). And arthritis in my wrists meant that those bed-to-walker transfers were not optimally safe.

What about multitasking, 12-hour shifts?

My difficulty in providing physical care made me wonder whether my cognitive skills, too, might not be up to managing the pace and pressure of floor work today. I may still be good at supporting and teaching, but can I multitask through 12 hours of nonstop problem-solving and decision-making?

In “When Is It Time to Leave Nursing?” in this month’s AJN, nurse Janet Blake (a […]

Betsy Todd, MPH, RN2019-05-21T12:18:44-04:00May 21st, 2019|career, Nursing|0 Comments

Nursing Homes: A ‘Place No One Wants to Be’

I’m on my way home from Atlanta, site of the 2018 NICHE (Nurses Improving Care for Healthsystem Elders) conference. This organization, housed at New York University-Rory Meyers College of Nursing for the last 26 years, provides education and consultation to organizations to improve the delivery of health care to older adults. It now counts over 700 member organizations in five countries and has been successful in helping facilities implement best practices for providing care to older adults.

Redesigning long-term care.

One of the speakers, Migette Kaup, PhD, from Kansas State University and an expert in designing care facilities, spoke about current efforts to redesign long-term care. She noted that traditional nursing homes, which were designed to mimic hospitals, are “a product no one wants” and a place many people would rather die than go to.

Kaup spoke about the success of the newer “household” model of long-term care, which mimics a home setting rather than a hospital. Key aspects of this model are that it centers around an open kitchen space and is made up of a dedicated staff and small group of residents who live together and implement best practices. Kaup cited successes in decreasing depression and pressure ulcers in low-risk patients, among other parameters. Of course the real goal, as we know, […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-04-13T11:43:57-04:00April 13th, 2018|family caregiving, Nursing, nursing perspective|3 Comments

Meeting the Nutritional Needs of Older Patients and Family Members

When copies of the print version of this month’s issue arrived in the office, AJN staff found different meanings in the Albert Anker painting (circa. 1895) that graces the cover. Is the man enjoying a cup of tea in peace and quiet, or is he isolated and lonely, perhaps sipping tea to stave off hunger because there isn’t much food in the house?

The artist’s intent may be open to interpretation, but we chose this cover because it suggests one of the many social, cognitive, physical, and economic factors that can affect the nutritional status of older adults: eating alone.

Many older adults are at risk.

In a March CE article, “Malnutrition in Older Adults,” registered dietitian Ann Reed Mangels, PhD, RD, FADA, summarizes the latest information on malnutrition in older adults, including risk factors, assessment tools, and practical ways in which nurses as well as family and friends can help to ensure good nutrition for elders in the community or in long-term care. Writes Mangels: