Family Caregivers Increasing in Age, Numbers: How Can Nurses Help?

By Shawn Kennedy, MA, RN, AJN editor-in-chief

AJNFamilyCaregiverSupplementLast week, a new report from the National Alliance for Caregiving and AARP detailed the landscape of family caregiving in the United States. The majority (60%) of caregivers remain female (40% are men, a percentage that continues to rise). They average 49 years of age. In most cases, they are caring for a relative (typically, a 69-year-old female). On average, the caregiver spends 24 hours each week helping with daily activities and has been doing so for four years; one-third of caregivers still maintain a full-time job.

An estimated 34.2 million adults provided unpaid care to an adult 50 years or older in the previous 12 months; nearly one in 10 caregivers is 75 years or older—a typical example given in the report was a 79-year-old female caring for a 77-year-old spouse with Alzheimer’s disease, aging issues, or heart disease. Half of caregivers were thrust into caregiving and felt that they had no choice about taking on the responsibility of a loved one’s care; 22% of caregivers feel that their own health has suffered.

To raise awareness of their needs, in recent years AARP has championed the plight of family caregivers, collaborating with government and consumer organizations, and health care professionals. AJN, too, has worked with AARP on several projects to provide nurses with information to support family […]

A Program of Mindfulness Practice for Nurses at a Boston Cancer Center

By Jacob Molyneux, senior editor

The Thea and James Stoneman Healing Garden at the Dana-Farber Cancer Institute is a source of tranquility and relaxation for nurses, patients, and families. Photo by Sam Ogden, Dana-Farber Cancer Institute. The Thea and James Stoneman Healing Garden at the Dana-Farber Cancer Institute is a source of tranquility and relaxation for nurses, patients, and families. Photo by Sam Ogden, Dana-Farber Cancer Institute.

Maybe you already practice some version of meditation or mindfulness in your daily life. If not, you may at least have read or watched a news story recently about mindfulness and its various uses with or by everyone from elementary school students to professional athletes to drug addicts in recovery to CEOs looking to improve their focus, as well as many of the rest of us.

Or maybe you saw the final episode of the television series Mad Men a few weeks ago, with the advertising man Don Draper sitting cross-legged at a California coastal retreat, deep in meditation.

Some critics of a […]

A Nurse Epidemiologist’s Notes on Issues Raised by a Recent Death from Lassa Fever

By Betsy Todd, MPH, RN, CIC, AJN clinical editor

Lassa fever is most often diagnosed by using enzyme-linked immunosorbent serologic assays (ELISA), which detect IgM and IgG antibodies as well as Lassa antigen. Reverse transcription-polymerase chain reaction (RT-PCR) can be used in the early stage of disease. The virus itself may be cultured in 7 to 10 days, but this procedure should only be done in a high containment laboratory with good laboratory practices. Immunohistochemistry, performed on formalin-fixed tissue specimens, can be used to make a post-mortem diagnosis.

Some aspects of last month’s case of Lassa fever in New Jersey seemed to parallel the story of Thomas Duncan, who died last October in Dallas after contracting Ebola virus disease in Liberia.

A man arrived in the U.S. from Western Africa. He was screened for Ebola at the airport and instructed to monitor his temperature […]

Recalling the Why of Health Care Reform

By Jacob Molyneux, AJN senior editor ACA ruling imageIn a brief analysis of the gradual rollout and effects so far of the Affordable Care Act (ACA) at the start of this year (“The ACA Continues to Run the Gauntlet”), I reviewed a few of the issues the law was intended to address when it was passed in 2010:

* the highest per capita expenditures of any health care system in the world

* consistently worse outcomes on measures such as infant mortality rate than most other developed nations

* increasing numbers of uninsured Americans each year, to over 50 million in 2009, the year before passage of the ACA

* unsustainable annual increases in health insurance premiums and drugs costs, leading to astonishing rates of medical bankruptcy

* a Medicare reimbursement process that rewarded the volume of care provided rather than the effectiveness of that care

These worsening issues had become impossible to ignore. No one believes the ACA is a perfect law; there were too many cooks in the kitchen for that. But it’s at least a good faith attempt to address real problems, to get a framework on the table that can potentially be improved upon. […]

Measles 101: The Basics for Nurses

While debates about measles vaccination swirl around the current U.S. measles outbreak, most U.S. nurses have never actually seen the disease itself, and right now we are a lot more likely to encounter a case of measles than of Ebola virus disease. Here, then, is a measles primer.

Symptoms.

Measles is an upper-respiratory infection with initial symptoms of fever, cough, runny nose, red and teary eyes, and (just before the rash appears) “Koplik spots” (tiny blue/white spots) on a reddened buccal mucosa. The maculopapular rash emerges a few days after these first symptoms appear (about 14 days after exposure), beginning at the hairline and slowly working its way down the rest of the body.

Infected people who are severely immunosuppressed may not have any rash at all. “Modified” measles, with a longer incubation period and sparse rash, can occur in infants who are partially protected by maternal antibodies and in people who receive immune globulin after exposure to measles.

Transmission.

The virus spreads via respiratory droplets and aerosols, from the time symptoms begin until three to four days after the rash appears. (People who are immunosuppressed can shed virus and remain contagious for several weeks.) Measles is highly contagious, and more than 90% of exposed, nonimmune people will contract the disease. There is no known asymptomatic carrier state, and no […]

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