Matching Items (12)
Description
The purpose of this study is to identify the needs of older adults with Alzheimer's disease (AD) and related dementias (ADRD) admitted to a rehabilitation setting where they are expected to physically and mentally function to their optimal level of health. To date, no studies have identified the needs and concerns of ADRD patients in rehabilitation settings. The Needs-Driven Dementia-Compromised Behavior (NDB) Model, the researcher's clinical experience, and the state of the current scientific literature will help guide the study. An exploratory qualitative research approach was employed to gather data and discover new information about the ADRD patient's needs and related behavioral outcomes. The qualitative findings on the discrepancies and similarities in perceptions of ADRD patient needs were obtained by examining formal and informal caregivers' perceptions. The researcher recruited registered nurses and certified nurse assistants (RNs and CNAs, formal) and family/friends (informal) who have provided care to patients in inpatient rehabilitation facilities to participate in focus groups and individualized focused interviews. The data were collated and analyzed using a thematic analysis approach. The overarching theme that developed as a result of this approach revealed discordant perceptions and expectations of ADRD patients' needs between the formal and informal caregivers with six subthemes: communication and information, family involvement, rehabilitation nurse philosophy, nursing care, belonging, and patient outcomes. The researcher provided recommendations to help support these needs. These findings will help guide the development of nurse-lead interventions for ADRD patients in a rehabilitation setting.
ContributorsAllen, Angela Marie (Author) / Coon, David W. (Thesis advisor) / McCarthy, Marianne (Committee member) / Uriri-Glover, Johannah (Committee member) / Arizona State University (Publisher)
Created2014
Description
Background: Heart failure is the leading cause of hospitalization in older adults and has the highest 30-day readmission rate of all diagnoses. An estimated 30 to 60 percent of older adults lose some degree of physical function in the course of an acute hospital stay. Few studies have addressed the role of posture and mobility in contributing to, or improving, physical function in older hospitalized adults. No study to date that we are aware of has addressed this in the older heart failure population.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
Purpose: To investigate the predictive value of mobility during a hospital stay and patterns of mobility during the month following discharge on hospital readmission and 30-day changes in functional status in older heart failure patients.
Methods: This was a prospective observational study of 21 older (ages 60+) patients admitted with a primary diagnosis of heart failure. Patients wore two inclinometric accelerometers (rib area and thigh) to record posture and an accelerometer placed at the ankle to record ambulatory activity. Patients wore all sensors continuously during hospitalization and the ankle accelerometer for 30 days after hospital discharge. Function was assessed in all patients the day after hospital discharge and again at 30 days post-discharge.
Results: Five patients (23.8%) were readmitted within the 30 day post-discharge period. None of the hospital or post-discharge mobility measures were associated with readmission after adjustment for covariates. Higher percent lying time in the hospital was associated with slower Timed Up and Go (TUG) time (b = .08, p = .01) and poorer hand grip strength (b = -13.94, p = .02) at 30 days post-discharge. Higher daily stepping activity during the 30 day post-discharge period was marginally associated with improvements in SPPB scores at 30 days (b = <.001, p = .06).
Conclusion: For older heart failure patients, increased time lying while hospitalized is associated with slower walking time and poor hand grip strength 30 days after discharge. Higher daily stepping after discharge may be associated with improvements in physical function at 30 days.
ContributorsFloegel, Theresa A (Author) / Buman, Matthew P (Thesis advisor) / Hooker, Steven (Committee member) / Dickinson, Jared (Committee member) / DerAnanian, Cheryl (Committee member) / McCarthy, Marianne (Committee member) / Arizona State University (Publisher)
Created2015
Description
Previous research has found improvements in motor and cognitive measures following Assisted Cycle Therapy (AC) in adolescence with Down syndrome (DS). Our study investigated whether we would find improvements in mental health in older adults with DS as measured from the Adapted Behavior Dementia Questionnaire (ABDQ), Physical Activity Self Efficacy Scales (PACES), Children's Depressive inventory, which are early indicators of Alzheimer's disease (AD) in persons with Down syndrome. This study consisted of seven participants with Down syndrome between the ages of 31 and 54, inclusive, that cycled for 30 minutes 3 x/week for eight weeks either at their voluntary cycling rate (VC) or approximately 35% faster with the help of a mechanical motor (ACT). Our results were consistent with our prediction that self efficacy improved following ACT, but not VC. However, our results were not consistent with our prediction that dementia and depression were improved following ACT more than VC. These results were interpreted with respect to the effects of exercise in older adults with DS. Future research should focus on recruiting more participants, especially those with deficits in mental health.
ContributorsPandya, Sachin (Author) / Ringenbach, Shannon (Thesis director) / Coon, David (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Description
The current literature on successful aging continues to grow, however it lacks a consistent definition of successful aging. Throughout the literature there are multiple themes and ideas that have been used to define successful aging by varying age groups. The current study took a similar approach by evaluating data gathered on older adults age 95 and older through a prescreen performed as part of the Longevity Study. The prescreen consisted of demographic information and self-reported contributors of successful aging. The demographic results demonstrated that the mean age was 98.4 (SD=2.40), with the majority of participants being widowed, living alone, in a single family home, and with some college or associates degree. The demographics varied between genders, with the key difference that men are more likely to be married and, therefore, live with someone. Self-reported contributors to successful aging exhibited that men and women had the same top three overall responses: positive attitude, diets, and biological; however, the rank order of these responses differed by gender. Also, the men more frequently picked marriage and spouse as key contributors, whereas females chose social engagement and support. The possible reasons for these differences may be related to the male to female ratio in the older population and males being more likely than women to date or re-marry with some family and friend support after loss of a spouse. Moreover, women regardless of marital status do not usually find their spouse as the primary support source, and males favor their spouse as their primary support source. Understanding the perspective of the oldest old may help to create better prevention and interventions techniques, alongside improved future research studies.
ContributorsRana, Harnoor (Author) / Coon, David (Thesis director) / O'Connor, Kathy (Committee member) / School of Nutrition and Health Promotion (Contributor) / Barrett, The Honors College (Contributor)
Created2016-05
Does assisted cycle therapy influence activities of daily living in older adults with Down syndrome?
Description
The aim of this study is to examine the relationship between Assisted Cycle Therapy, leisure time activity levels, fine motor control, and grip force in older adults with Down syndrome (DS), all of which affect activities of daily living (ADL) and therefore quality of life. This is relevant because this particular group is at risk for developing early onset Alzheimer's disease (AD), which presents itself uniquely in this population. The parent or guardian of six participants with DS completed Godin's Leisure Time Exercise Questionnaire and the participants themselves completed Purdue Pegboard and grip force assessments before and after an 8-week exercise intervention. The results were inconsistent with past research, with no change being seen in fine motor control or grip force and a decrease being seen in leisure activity. These findings are indicative of the importance of the effect of fatigue on leisure activity as well as maintaining elevated heart rate throughout exercise interventions.
ContributorsGomez, Elizabeth Danielle (Author) / Ringenbach, Shannon (Thesis director) / Coon, David (Committee member) / Barrett, The Honors College (Contributor) / T. Denny Sanford School of Social and Family Dynamics (Contributor) / Department of Psychology (Contributor)
Created2015-05
Description
As people age, the desire to grow old independently and in place becomes larger and takes greater importance in their lives. Successful aging involves the physical, mental and social well-being of an individual. To enable successful aging of older adults, it is necessary for them to perform both activities of daily living (ADL) and instrumental activities of daily living (IADL). Embedded assessment has made it possible to assess an individual's functional ability in-place, however the success of any technology depends largely on the user than the technology itself. Previous researches in in-situ functional assessment systems have heavily focused on the technology rather than on the user. This dissertation takes a user-centric approach to this problem by trying to identify the design and technical challenges of deploying and using a functional assessment system in the real world.
To investigate this line of research, a case study was conducted with 4 older adults in their homes, interviews were conducted with 8 caregivers and a controlled lab experiment was conducted with 8 young healthy adults at ASU, to test the sensors. This methodology provides a significant opportunity to advance the scientific field by expanding the present focus on IADL task performance to an integrated assessment of ADL and IADL task performance. Doing so would not only be more effective in identifying functional decline but could also provide a more comprehensive assessment of individuals' functional abilities with independence and also providing the caregivers with much needed respite.
The controlled lab study tested the sensors embedded into daily objects and found them to be reliable, and efficient. Short term exploratory case studies with healthy older adults revealed the challenges associated with design and technical aspects of the current system, while inductive analysis performed on interviews with caregivers helped to generate central themes on which future functional assessment systems need to be designed and built. The key central themes were a) focus on design / user experience, b) consider user's characteristics, personality, behavior and functional ability, c) provide support for independence, and d) adapt to individual user's needs.
To investigate this line of research, a case study was conducted with 4 older adults in their homes, interviews were conducted with 8 caregivers and a controlled lab experiment was conducted with 8 young healthy adults at ASU, to test the sensors. This methodology provides a significant opportunity to advance the scientific field by expanding the present focus on IADL task performance to an integrated assessment of ADL and IADL task performance. Doing so would not only be more effective in identifying functional decline but could also provide a more comprehensive assessment of individuals' functional abilities with independence and also providing the caregivers with much needed respite.
The controlled lab study tested the sensors embedded into daily objects and found them to be reliable, and efficient. Short term exploratory case studies with healthy older adults revealed the challenges associated with design and technical aspects of the current system, while inductive analysis performed on interviews with caregivers helped to generate central themes on which future functional assessment systems need to be designed and built. The key central themes were a) focus on design / user experience, b) consider user's characteristics, personality, behavior and functional ability, c) provide support for independence, and d) adapt to individual user's needs.
ContributorsRavishankar, Vijay Kumar (Author) / Burleson, Winslow (Thesis advisor) / Coon, David (Committee member) / Mahoney, Diane (Committee member) / Walker, Erin (Committee member) / Li, Baoxin (Committee member) / Arizona State University (Publisher)
Created2015
Description
This manuscript option dissertation elucidates the role of patient-provider interactions in keeping HIV positive Black women in medical care. Since 2012, the Arizona State Department of Health has acknowledged that women of African descent are disproportionately affected by HIV and die at higher rates from AIDS-related complications than other women. The dissertation includes three manuscripts covering a feature of this topic. The first paper is a scoping review of literature on what is known about the influence of patient-provider relationships on adherence and viral suppression among Black women living with HIV in Arizona. The second is an empirical study built upon interviews with Black women living with HIV analyzed through constructivist grounded theory to understand women’s perspectives of provider actions that keep them in care. The third offers practice recommendations based on the interviews with Black women living with HIV, dialog with HIV advocates, and proceedings of the Phoenix Fast Track Cities ad hoc committee to end HIV as an epidemic. Together, the three manuscripts integrate the voices of women, advocates, and past research to support best practices and future steps for HIV retention strategies.
ContributorsHassan, Kenja (Author) / Coon, David W. (Thesis advisor) / McCarthy, Marianne (Committee member) / Uriri-Glover, Johannah (Committee member) / Arizona State University (Publisher)
Created2021
Description
Personal hygiene, as well as many other daily living tasks, is not often regarded as a stressful or traumatic event. Giving a bath or shower to a person with Alzheimer’s disease or related dementias (ADRD) is typically an ongoing struggle for caregivers around the world. Generally, taking a bath or shower results in hostility, arguing, combativeness, screaming and even crying. This study explores claims that live music decreases levels of stress during bathing for people with ADRD. To test this, qualitative data has been collected based on the observations of professional caregivers, and quantitative data has been collected based on the levels of cortisol, a human stress hormone, taken before and after bath times on music and non-music days. These preliminary results suggest that live music-based interventions may lessen the trauma experienced by the residents during bath times. Therefore, this study opens the door for more consistent use of music by nurses, nursing aids, and other caregivers to perform better care for people with memory-loss complications.
ContributorsMorici, Olivia Grace (Author) / Coon, David (Thesis director) / McCarthy, Marianne (Committee member) / Edson College of Nursing and Health Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2019-12
Description
Brought on by extended survival due to Highly Active Anti-Retroviral Therapy and increased incidence among older adults, the demographic profile of the HIV epidemic has begun to shift towards the aging population. As people living with HIV (PLWH) begin to age and develop multiple comorbidities, their needs are no longer limited to HIV treatment and disease management; they may require aging services similar to those with a negative HIV status. Increased attention has been placed on HIV and aging to assess the unique needs of older PLWH, however, limited research exists on the preparedness of aging services to provide adequate care to this population. This study aims to assess HIV and aging within Maricopa County, where individuals aged 50 years and older account for nearly half the reported HIV/AIDS cases in the county, and 30% of cases in Arizona. Two focus groups – one with older PLWH and another with aging service professionals – were conducted to gather information about existing aging services and the perspectives of older PLWH regarding their growing needs. Older PLWH were found to experience challenges similar to those that have been well-documented in previous studies: most notably, PTSD and other mental health conditions; fear of the future and isolation; HIV status disclosure and stigma; and economics and financial security. An anonymous survey was developed in conjunction with Aunt Rita’s Foundation to evaluate Maricopa County aging services; it was discovered that providers lack experience with HIV and admit deficiencies in their preparation to address the age-related concerns of older PLWH. The results show that the majority of providers were supportive of offering care to older PLWH and expressed interest in improving their preparedness. Future research is necessary to obtain perspectives from additional aging services in Maricopa County and word towards the development of an aging services directory to connect older PLWH to care.
ContributorsLayon, Sarah (Author) / Jacobs, Bertram (Thesis director) / Coon, David (Committee member) / Spencer, Glen (Committee member) / School of Life Sciences (Contributor) / School of Human Evolution & Social Change (Contributor) / School of Art (Contributor) / Barrett, The Honors College (Contributor)
Created2019-05
Description
This paper will provide a review of the difficulties associated with caregiving for a family member with Alzheimer’s Disease and Related Dementias (ADRD) and the intervention strategies used to improve psychosocial wellbeing of the caregiver. A review of various empirical studies compares different intervention strategies and their accessibility and effect on caregiver mental health. The literature suggests that the most effective treatments are those that are based in cognitive behavioral techniques , teaching caregivers how to recognize and regulate negative emotions that arise and to develop coping strategies for stressful situations involving their loved one with ADRD (Cheng et al., 2018). However, there is currently only a limited amount of research done on the topic of pain recognition and management by caregivers for those with ADRD; future research on this topic is needed to help to develop programs to teach caregivers strategies to help them recognize changes associated with pain in their loved one’s health and wellbeing (Kankkunen & Valimaki, 2014). Future research regarding caregivers for those with ADRD will continue to improve the development of family based support programs based in education for recognition of pain symptoms in patients and cognitive behavioral principles to improve caregiver and patient quality of life (Gitlin et al., 2015).
ContributorsKinnier, Amber (Author) / Coon, David (Thesis director) / Hanish, Laura (Committee member) / Sanford School of Social and Family Dynamics (Contributor) / Barrett, The Honors College (Contributor)
Created2020-05