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Preventing, identifying and managing delirium in nursing homes and acute settings
Older people, particularly those in nursing homes, are vulnerable to delirium, which is a condition characterised by confusion. This article outlines the risk factors, prevention, identification and management of delirium in older people in nursing homes and acute settings. It uses a case study approach to encourage nurses to consider the challenges faced in these settings and how they could address delirium. The article also details the multicomponent interventions that can be used for prevention, as well as the available delirium assessment tools, with a focus on selecting tools based on the person’s health status and the healthcare setting.
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Holistic pain assessment in older people and older people living with dementia
Pain occurs in a wide range of diseases and long-term conditions associated with ageing and can affect every aspect of an individual’s life, reducing their ability to recover, their independence and their quality of life.The assessment of pain is an important aspect of nurses’ role and requires them to obtain detailed information on how the older person experiences pain and how pain is affecting their life. However, there are many challenges to effective pain assessment in older people, including challenges concerning communication and cognition.This article provides an overview of pain assessment in older people, particularly those living with dementia, based on the author’s expertise and on relevant literature, notably the recently revised UK national guidelines on the assessment of pain in older people.
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Sexually speaking: person-centred conversations with people living with a dementia
While sexuality is integral to being human and supporting sexual expression is fundamental to delivering person-centred care, many nurses find this area challenging. This is particularly true when working with people living with a dementia, irrespective of their age. However, it can be especially challenging in older adults.This article aims to support nurses in their work with individuals and couples living with a dementia. After briefly defining the term ‘sexuality’ and acknowledging the effects of the most common types of dementia, the article discusses the importance of person-centred conversations. It details a new person-centred paradigm that can assist nurses to learn about people’s sexuality and sexual wishes. Through enhanced understanding and increased objectivity, nurses can be better equipped to support people to continue living fulfilled sexual lives according to their choices and priorities. The article concludes by summarising the legal and professional context and nursing responsibilities involved in addressing sexuality with people living with a dementia, specifically when mental capacity becomes an issue.
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Sexual health and well-being in later life
Sexual health in later life is becoming increasingly important as more people are reaching older age and are remaining sexually active well into their seventies and beyond. Alongside this, as more older people seek new relationships following partner death or divorce, the rates of newly diagnosed sexually transmitted infections are increasing markedly.This article focuses on sexual health and well-being. It offers a definition of sexual health and explores the changes that people experience in sexual health, well-being and functioning in later life. It discusses common physical, psychosocial and sexual relationship issues, and identifies advice that nurses can offer to older people. Using the PLISSIT model, it then focuses on the role of nurses in promoting sexual health for people in later life.
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Hilda Hand
Complete photograph album
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Demonstrating empathy when communicating with older people
Empathy is an integral aspect of communication with older people and is central to person-centred care. As part of the provision of person-centred care, empathy supports effective communication, producing positive effects such as increased emotional well-being, increased adherence to treatment plans, reduced pain levels and improved wound healing. Empathy involves attempting to understand the other person’s perspective and feelings and communicate that understanding back to them. Empathic communication can help older people feel that they are being listened to and valued as partners in healthcare relationships.This article focuses on why it is important to demonstrate empathy when communicating with older people and how this can be achieved. It explains the origin of the concept of empathy in nursing and provides different ways of characterising empathy. It explores barriers to empathic communication in older people nursing and identifies verbal and non-verbal communication skills that nurses can use to enhance their empathy. Finally, it explains the importance for nurses to develop self-awareness and undertake self-care to preserve their capacity to demonstrate empathy towards older people.
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Using team formulation in mental health practice
Formulation is a process of developing an understanding of what is happening for a person and why, and therefore what might be helpful for them. It involves gathering information, drawing from personal meanings and theoretical understandings to develop a coherent narrative. Traditionally, formulation is undertaken by a practitioner and a service user on an individual basis, but it can also be undertaken in a team context.This article explores team formulation, outlining its ideas, implementation and potential effects. It describes some of the evidence, outlines some techniques that can be used and reflects on team formulation in practice. However, it is not a systematic review of the evidence. It is hoped that this process will enable readers to develop an enhanced awareness of the concepts and issues involved, feel more confident engaging in team formulation and recognise the challenges and value that it can bring to clinical practice.
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Sexual violence: a trauma-informed approach for mental health nurses supporting survivors
It has been recognised that there is a likely high prevalence of trauma originating in sexual violence among people who receive care in inpatient mental health settings. Mental health nurses working in inpatient settings are therefore highly likely to encounter, knowingly or not, survivors of historical and/or recent sexual violence in their practice. This article enhances mental health nurses’ understanding of the effects of sexual violence on survivors, explains the principles of trauma-informed care, and outlines strategies that nurses can adopt to promote the recovery of service users who have experienced sexual violence.
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Supporting women’s sexual safety in acute mental health settings
Sexual safety in mental health settings is being increasingly recognised as a complex issue and a crucial aspect of organisational and practice responsibilities. However, concerns have been raised in relation to sexual safety for service users admitted to mental health inpatient wards in the UK. While sexual safety is a concern for everyone, the experiences and nature of concerns may vary across different groups and between individuals. It is also acknowledged that although interest in sexual safety is increasing, there remains limited evidence available from the perspectives of those who use mental health services. This article defines sexual safety and discusses its various components, and discusses a project that was undertaken to explore women’s perspectives and experiences of sexual safety in inpatient mental health settings. It also provides recommendations for maintaining sexual safety in clinical practice.
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Understanding and applying personality types in healthcare communication
Understanding personality types can assist nurses in enhancing their understanding of themselves and their colleagues, which in turn can support effective communication. This article outlines the principles of the Myers-Briggs Type Indicator (MBTI) – a personality inventory that aims to improve the understanding of psychological types – and details the characteristics of the MBTI’s 16 different personality types. The article explores how these 16 personality types can influence communication within healthcare teams and between healthcare professionals. It also discusses how these personality types affect styles of nurse leadership and how an understanding of personality types can improve nurses’ communication with patients.
