Off the Charts

Helping Family Caregivers with Fall Prevention in the Home

“Because mobility in later life results in positive health benefits but increases exposure to falls, many researchers and health care providers in geriatric nursing and medicine have called for ensuring safe mobility while protecting older adults from harm. It’s especially important to identify strategies that can potentially reduce the risk of fall-related injuries in older adults.This increasing focus on fall-injury prevention—in addition to fall prevention—represents a major shift in safety practice.”

(Click image to enlarge)

How can nurses best help family caregivers?

How can nurses help family caregivers identify fall risk in their family members, prevent falls, and respond to them if they occur?

According to the authors of “Preventing Falls and Fall-Related Injuries at Home“—the latest in our ongoing series of articles and videos, Supporting Family Caregivers: No Longer Home Alone—the need for better education and resources on such topics is widespread among family caregivers:

“In a national survey of caregivers who provide unpaid care to a relative or friend, 46% reported they assisted with medical and nursing tasks. Of these, 43% said such help involved the use of assistive mobility devices, such as walkers or canes. Almost half of family caregivers are also known to […]

Share this:
Facebook
Bluesky
X
LinkedIn

Jacob Molyneux, senior editor/blog editor2018-01-25T10:24:11-05:00January 25th, 2018|family caregiving, family caregiving, Nursing, patient safety|0 Comments

Honoring the Moral Concerns of Caregivers Afraid of Giving Morphine

Joan’s breathing relaxes as the morphine starts working. Her son Travis, on the other hand, is clearly upset as we sit at her bedside where she is dying. Despite his mother’s intense respiratory distress before he gave her the morphine, he’s convinced that he’s just made a big mistake. “I’m sorry, mama,” he whispers.

He turns his head my way. “I wish you hospice folks had never brought that morphine out here,” he says. “Now she’s dead for sure and it’s my fault.”

A sometimes essential medication.

For caregivers with this level of fear about morphine, it’s a painful dilemma. If you don’t use the best, sometimes the only, medication we have for getting acute respiratory distress in terminally ill patients under control, both patient and caregiver suffer. But if giving morphine is freighted, as it is for Travis, with a belief that it causes death and/or signifies giving up on, even betraying, a loved one, it can intensify a caregiver’s distress.

The hospice nurse had already given the standard education, assuring Travis that in patients near the end of life morphine is safe and effective when used as prescribed. We had given him written information debunking some of the common myths about morphine—“it kills you”; “makes you crazy”; “it’s addictive”—when used appropriately with hospice patients who have active symptoms. We had promised to […]

Guest Author2018-01-22T10:19:38-05:00January 22nd, 2018|Ethics, family caregiving, Nursing, pain management|0 Comments

How to Identify and Avoid Predatory Journals

Photo by Alice Rosen, via Flickr.

I remember receiving my first “accept” letter for a novel I was working on many years ago. In my excitement, I didn’t stop to think that it was strange that, before the editor began working with me, I would have to pay a large sum of money to get the manuscript into shape. When my euphoria died down and my skepticism shot up, I decided to submit a fake query to the same publisher, highlighting a novel that could never possibly get published. Imagine my dismay when I received the exact same acceptance letter.

So in a way, predatory publishing is not an entirely new concept. And in fact, many more or less legitimate self-publishing options for books, fiction or otherwise, still exist. But with the increasing dominance of the Web and the rise of the open access movement—established to help spread publicly funded research—a more invidious and widely pervasive form of predatory publishing has taken hold in scholarly publishing. And the stakes are far higher. While my novel probably wasn’t going to affect anyone’s life, articles published by unscrupulous publishers—especially medical and nursing literature—have a lot more power to cause damage.

Flawed, unreliable content.

Since predatory journals often forego rigorous peer review, […]

Amy M. Collins, managing editor2018-01-19T10:56:23-05:00January 19th, 2018|digital health, nursing research, writing|0 Comments

Pain, an Ever-Present Concern for Patients—and Nurses

Nurses at Ann and Robert H. Lurie Children’s Hospital of Chicago manage baby boy’s postoperative pain following heart transplant. Photo courtesy of Ann and Robert H. Lurie Children’s Hospital.

In my experience working with severely ill or injured patients, pain was what they talked about the most. They either asked about it prior to a treatment or intervention (“How much is this going to hurt?”), relived their history with it (“This pain isn’t as bad as the pain I had….”), or were consumed with fear that it would never end (“I can’t handle this—can’t they give me anything for it?”).

Post-op patients mostly had the same standard order, whether they were slightly built women or burly men: meperidine 25mg q3-4 h IM. I remember watching the time so I could administer the medication as soon as the clock would allow—and sometimes “fudging” the time a bit because the medication wasn’t “holding” the patient. It was one of the topmost issues for nurses in acute care—how to ensure patients were comfortable and pain free. As a nurse, not being able to provide […]

Shawn Kennedy, MA, RN, FAAN, editor-in-chief (emerita)2018-01-17T10:04:37-05:00January 17th, 2018|Nursing|0 Comments

A Dream of Horses: An Aging Veteran’s Healing Encounter

“Let’s go for a ride,” I said to Joe as he lay expressionless on his bed, covered in blankets and staring at the ceiling. The room was stuffy with hot, stale air. No bigger than a walk-in closet, the space held the lifetime possessions, many of them scattered on the bed, floor, and windowsill, of a 75-year-old veteran residing in an assisted living facility. Joe appeared frail and bored in the silence of the room.

Illustration by Janet Hamlin for AJN.

That’s the start of the Reflections column, “A Dream of Horses,” in the January issue of AJN. Written by a nurse at the Department of Veterans Affairs, the short, moving essay describes a series of healing encounters between a frail older man, who seems to have given up on life, and the horses at a therapeutic equestrian barn.

The here and now.

The story told here reminds us how much we humans can cocoon ourselves against the more elemental forces of the natural world, and how healing it can be to encounter a magnificent animal that asks only that we be present in the here and now. The senses awaken. We look beyond our own habitual ways of thinking and […]

Jacob Molyneux, senior editor/blog editor2018-01-16T10:00:35-05:00January 16th, 2018|Nursing, nursing stories, Patients|0 Comments