The Portal of Geriatrics Online Education

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Oral Hygiene & Care-resistant Behaviors: Making a Difference

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Intended Learner Audiences: 
Other Sponsors: 
Product Information
Estimated time to complete: 
1
Abstract: 

This video addresses care-resistant behavior exhibited by persons with dementia within the context of oral hygiene. Care-resistant behavior includes any actions on the part of the person with dementia to evade or avoid activities of daily living. Care-resistant behavior is theorized to be a reaction to a perceived threat; that is, the person with dementia interprets the caregiving activity as an assault or sees the caregiver as a person intent to doing harm. Oral hygiene activities, such as brushing the teeth or removing dentures, involve close proximity between the elder and the caregiver. This closeness heightens threat perception on the part of the elder with dementia. Several strategies to prevent and reduce care-resistant behavior are described and depicted in the video. Some of the strategies include promoting as much independence as possible, using nonverbal communication, and avoiding elderspeak.

Educational objectives: 

After watching this video, participants will be able to:

1. Describe how caregiving activities can be misinterpreted as threat by persons with dementia;

2. Identify care-resistant behavior in the context of oral hygiene activities;

3. Demonstrate at least one technique to prevent or reduce care-resistant behavior during oral hygiene activities.

 

Additional information/Special implementation requirements or guidelines: 

Content in this video was based on the following sources:

Oral-Systemic Link

      Azarpazhooh A, Leake JL. Systematic review of the association between respiratory diseases and oral health. J. Periodontol. 2006;77(9):1465-1482. doi:10.1902/jop.2006.060010.

      Bakhshandeh S, Murtomaa H, Mofid R, Vehkalahti MM, Suomalainen K. Periodontal treatment needs of diabetic adults. J. Clin. Periodontol. 2007;34(1):53-57. doi:10.1111/j.1600-051X.2006.01028.x.

     Furukawa T, Wakai K, Yamanouchi K, et al. Associations of Periodontal damage and tooth loss with atherogenic factors among patients with type 2 diabetes mellitus. Intern. Med. 2007:1359-1364. doi:10.2169/internalmedicine.

    Desvarieux M, Demmer RT, Rundek T, et al. Periodontal microbiota and carotid intima-media thickness: the Oral Infections and Vascular Disease Epidemiology Study (INVEST). Circulation. 2005;111(5):576-582. PMCID:PMC2812915.

     Desvarieux M, Demmer RT, Rundek T, et al. Relationship Between Periodontal Disease, Tooth Loss, and Carotid Artery Plaque: The Oral Infections and Vascular Disease Epidemiology Study. Stroke. 2003(9):2120-2125. PMCID:PMC2677013. doi:10.1161/01.STR.0000085086.50957.22.

      Promsudthi A, Pimapansri S, Deerochanawong C, W. K. The effect of periodontal therapy on uncontolled type2 diabetes mellitus in older subjects. Oral Dis. 2005;11:293-298. doi:10.1111/j.1601-0825.2005.01119.x.

      Quagliarello V, Ginter S, Han L, Van Ness P, Allore H, Tinetti M. Modifiable risk factors for nursing home-acquired pneumonia. Clin. Infect. Dis. 2005;40(1):1-6. doi:10.1086/426023.

     Terpenning M. Geriatric oral health and pneumonia risk. Clin. Infect. Dis. 2005;40(12):1807-1810. doi:10.1086/430603.

 

Care-Resistant Behavior as Response to a Perceived Threat

      Corcoran KA, Desmond TJ, Frey KA, Maren S. Hippocampal inactivation disrupts the acquisition and contextual encoding of fear extinction. J. Neurosci. 2005;25(39):8978-8987. doi:10.1523/JNEUROSCI.2246-05.2005.

      Henry JD, Thompson C, Ruffman T, et al. Threat perception in mild cognitive impairment and early dementia. J. Gerontol. B Psychol. Sci. Soc. Sci. 2009;64B(5):603-607. doi:10.1093/geronb/gbp064.

      LaBar KS, Torpey DC, Cook CA, et al. Emotional enhancement of perceptual priming is preserved in aging and early-stage Alzheimer's disease. Neuropsycologia. 2005;43:1824-1837. doi:10.1016/j.neuropsychologia.2005.01.018.

      LeDoux J. The emotional brain, fear, and the amygdala. Cell. Mol. Neurobiol. 2003;23(4-5):727-738. doi:10.1023/A:1025048802629.

      Luzzi S, Piccirilli m, Provinciali L. Perception of emotions on happy/sad chimeric faces in Alzheimer's Disease: Relationship with cognitive functions. Alzheimer Dis. Assoc. Disord. 2007;21(2):130-135. doi:10.1097/WAD.0b013e318064f445.

      Maren S. Building and burying fear memories in the brain. Neuroscientist. 2005;11(1):89-99. doi:10.1177/1073858404269232.

      Ohman A. The role of the amygdala in human fear: automatic detection of threat. Psychoneuroendocrinology. 2005;30(10):953-958. doi:10.1016/j.psyneuen.2005.03.019.

Mouth Care Protocol

      American Dental Association. Oral health topics: dentures.  http://www.ada.org/2996.aspx. Accessed 2010/02/23/.

      American Dental Association. Cleaning your teeth and gums (oral hygiene).  http://www.ada.org/2624.aspx. Accessed 2010/02/23/.

      Chalmers J, Johnson V, Tang JH, Titler MG. Evidence-based protocol: oral hygiene care for functionally dependent and cognitively impaired older adults. J. Gerontol. Nurs. 2004;30(11):5-12.

      Gil-Montoya JA, de Mello AL, Cardenas CB, Lopez IG. Oral health protocol for the dependent institutionalized elderly. Geriatr. Nurs. 2006;27(2):95-101. doi:10.1016/j.gerinurse.2005.12.003.

 

Interventions to Reduce Care-Resistant Behavior

      Beck C, Heacock P, Mercer SO, Walls RC, Rapp CG, Vogelpohl TS. Improving dressing behavior in cognitively impaired nursing home residents. Nurs. Res. 1997;46(3):126-132. doi:10.1097/00006199-199705000-00002.

      Burgener SC, Jirovec M, Murrell L, Barton D. Caregiver and environmental variables related to difficult behaviors in institutionalized, demented elderly persons. J. Gerontol. 1992;47(4):P242-249.

           Burnham H, Hogervorst E. Recognition of facial expressions of emotion by patients with dementia of the Alzheimer Type. Dement. Geriatr. Cogn. Disord. 2004;18:75-79. doi:10.1159/000077813.

        Chalmers JM. Behavior management and communication strategies for dental professionals when caring for patients with dementia. Spec. Care Dentist. 2000;20(4):147-154. doi:10.1111/j.1754-4505.2000.tb01152.x.

        Chalmers JM, Levy SM, Buckwalter KC, Ettinger RL, Kambhu PP. Factors influencing nurses' aides provision of oral care for nursing facility residents. Spec. Care Dentist. 1996;16(2):71-79. doi:10.1111/j.1754-4505.1996.tb00837.x.

      Chalmers J, Pearson A. Oral hygiene care for residents with dementia: a literature review. J. Adv. Nurs. 2005;52(4):410-419. doi:10.1111/j.1365-2648.2005.03605.x

      Herman R, Williams KN. Elderspeak's influence on resistiveness to care: Focus on behavioral events. Am. J. Alzheimers Dis. Other. Demen. 2009;24(5):417-423. doi:10.1177/1533317509341949.

      Mahoney EK, Hurley AC, Volicer L, et al. Development and testing of the Resistiveness to Care Scale. Res. Nurs. Health. 1999;22(1):27-38. doi:10.1002/(SICI)1098-240X(199902)22:1<27::AID-NUR4>3.0.CO;2-T.

      Sloane PD, Hoeffer B, Mitchell CM, et al. Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. J. Am. Geriatr. Soc. 2004;52(11):1795-1804. doi:10.1111/j.1532-5415.2004.52501.x.

      Somboontanont W, Sloane PD, Floyd FJ, Holditch-Davis D, Hogue CC, Mitchell CM. Assaultive behavior in Alzheimer's disease: identifying immediate antecedents during bathing. J. Gerontol. Nurs. 2004;30(9):22-29; quiz 55-26.

      Williams KN, Herman R, Gajewski B, Wilson K. Elderspeak communication: impact on dementia care. Am. J. Alzheimers Dis. Other. Demen. 2009;24(1):11-20. PMCID:PMC2823803. doi:10.1177/1533317508318472.

Publications from, presentations from, and/or citations to this product: 

Jablonski, R. A., Therrien, B., Mahoney, E., Kolanowski, A., Gabello, M., & Brock, A. (2011).  An Intervention to Reduce Care-Resistant Behavior in Persons with Dementia During Oral Hygiene: A Pilot Study. Special Care Dentistry.31(3): 77-87.

Jablonski, R.A. (2010). “Examining oral health in nursing home residents and overcoming mouth-care resistive behavior.” Annals of Long-Term Care: Clinical Care and Aging, 18(1), 21-26.

Date posted: 
Wed, 09/07/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 09/07/2011
Contact Person/Corresponding Author:



Suggested Citation:
Oral Hygiene & Care-resistant Behaviors: Making a Difference. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/44

Electronic References and other Information Resources for Clinicians

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This one hour video lecture with accompanying PowerPoint slides describes resources for clinicians and caregivers, including new on-line information sources. The target audience is Interdisciplinary Health Care Professionals.

Educational objectives: 
  1. List Evidence-based resources for clinicians.
  2. List free electronic resources for patients.
  3. Explain the functions of Eskind Biomedical library: Geriatrics Digital Library
Additional information/Special implementation requirements or guidelines: 

You will need to install the Microsoft Silverlight plugin to view this video. The video may take a while to load based on your connection. Please wait a few minutes if it doesn't appear right away.

Date posted: 
Fri, 06/08/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Fri, 06/08/2012
Contact Person/Corresponding Author:



Suggested Citation:
Electronic References and other Information Resources for Clinicians. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/44

Cultural Aspect of Health Care for Vietnamese American Seniors in the Nursing Home

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This presentation, including a discussion with a geriatrician and a Vietnamese community expert, outlines healthcare issues faced by Vietnamese American seniors living in skilled nursing homes.

Educational objectives: 
  • Review data pertaining to Vietnamese American seniors, particularly those living in skilled nursing facilities (SNFs)
  • Discuss some cultural aspects of healthcare for Vietnamese American seniors living in SNFs
Additional information/Special implementation requirements or guidelines: 

When presenting this lecture, make sure the lecture file is in the same folder on your computer as the video file. If you have difficulty playing the video in the PowerPoint, you may need to edit it within Microsoft Office. 

Date posted: 
Tue, 04/23/2013
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Tue, 04/23/2013
Contact Person/Corresponding Author:



Suggested Citation:
Cultural Aspect of Health Care for Vietnamese American Seniors in the Nursing Home. POGOe - Portal of Geriatrics Online Education; 2013 Available from: https://pogoe.org/taxonomy/term/44

Geriatric Emergency Medicine Online Curriculum (GEM-OC) 1 - Advance Directives

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Estimated time to complete: 
1
Abstract: 

This is Module One of an online five-module curriculum.  The modules, which are based on national geriatric emergency medicine competencies, cover a broad range of geriatric topics through an interactive teaching format.  They require learners to review and analyze patient information, interpersonal interactions, laboratory and imaging results, diagnoses and treatment plans. This module teaches advance directives and palliative care.

Educational objectives: 

At the end of Module One, the learner should be able to:

1) Define and differentiate among types of code status, health care proxies, and advance directives in the state where one is training.

2) Accurately identify clinical situations where life expectancy, functional status, patient preference and goals of care should override standard recommendations for screening and treatment in older adults.

3) Present palliative care (including hospice) as a positive, active treatment option for a patient with advanced disease.

4) Formulate a differential diagnosis and implement initial evaluation in a patient who exhibits dementia, delirium, or depression.

5) In an older patient with delirium, urgently initiate a diagnostic work-up to determine the root cause (etiology).

Additional information/Special implementation requirements or guidelines: 

For best viewing results, please:

  • Set your monitor resolution to 1024x768
  • Launch in either Internet Explorer 6 or higher, Firefox 2 or higher or Safari 3.2.1 or higher
  • Avoid using browser navigation. Use only the navigation provided within the course.

 

Date posted: 
Tue, 10/19/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 08/08/2011
Contact Person/Corresponding Author:



Suggested Citation:
, , , , , and . Geriatric Emergency Medicine Online Curriculum (GEM-OC) 1 - Advance Directives. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/44

Treatment of Elderly Patients with Metastatic Non-Small Cell Lung Carcinoma

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This presentation reviews clinical trials and directs the learner's attention to the under-representation of older patients in studies that address lung cancer treatment. It highlights the importance of performance status as a significant factor in how the patient will be impacted by the disease and its treatment, and discusses optimal treatment options available for the older patient with non-small cell lung cancer.

Educational objectives: 
  1. Review clinical studies on older patients with lung cancer, and
  2. Learn the optimal treatment options for older adults with non-small cell lung cancer.
Date posted: 
Wed, 01/19/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 01/19/2011
Contact Person/Corresponding Author:



Suggested Citation:
Treatment of Elderly Patients with Metastatic Non-Small Cell Lung Carcinoma. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/44

Utility of Comprehensive Geriatric Assessment for the Care of Older Adults with Cancer

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This lecture presentation addresses the importance of the interdisciplinary approach and the comprehensive geriatric assessment in treatment of older adults with cancer.

Educational objectives: 
  1. Learn about various components of comprehensive geriatric assessment, and
  2. Application of comprehensive geriatric assessment in older adults with cancer.
Date posted: 
Wed, 01/19/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 01/19/2011
Contact Person/Corresponding Author:



Suggested Citation:
Utility of Comprehensive Geriatric Assessment for the Care of Older Adults with Cancer. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/44

Clinical Applications of Latino Ethnogeriatrics

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This lecture presentation focuses on delivering health care for older Latino patients.

Educational objectives: 
  1. Understand what is meant by the term "Latino",
  2. Discuss most recent U.S. Latino demographics,
  3. Discuss health-related Latino elderly population characteristics,
  4. Understand clinically important relative health risks of Latino elderly,
  5. Expand history and physical exam skills to assess significant, culturally relevant findings, and
  6. Introduce targeted methods for delivering culturally appropriate geriatric care.
Date posted: 
Wed, 01/19/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 01/19/2011
Contact Person/Corresponding Author:



Suggested Citation:
Clinical Applications of Latino Ethnogeriatrics. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/44

Aging Q3 Website

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Other Learning Resource Type: 
Product Information
Abstract: 

Aging Q3 is an educational and practice-based program to improve resident physician clinical competencies in Geriatrics and improve the quality of care and quality of life for older adults. The website contains an overview of the Aging Q3 program and descriptive information for each ACOVE area. It also includes: working group members, didactic lecture, detailing sheets, patient education materials, and literary resources.  Each ACOVE area contains a project overview video and descriptive videos by the working group chair. 

Additional information/Special implementation requirements or guidelines: 

The three Qs of Aging Q3 signify:

  • Quality of Education
  • Quality of Care
  • Quality of Life
Date posted: 
Mon, 10/25/2010
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 10/25/2010
Contact Person/Corresponding Author:



Suggested Citation:
Aging Q3 Website. POGOe - Portal of Geriatrics Online Education; 2010 Available from: https://pogoe.org/taxonomy/term/44

A Guide to Developing A Medical Readers' Theater (MRT) Program

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Abstract: 

This step-by-step guide offers a roadmap for developing and starting a medical readers' theater (MRT) program.  MRT at UC Irvine School of Medicine is presented as a model for bringing together older adults and third-year medical students in order to share their perspectives on various health-related topics. 

Educational objectives: 
  1. To provide an overview of a medical readers' theater (MRT) program;
  2. To identify and describe the components of an MRT experience; and
  3. To recognize the value of MRT and its impact on the medical education of future physicians.
Date posted: 
Mon, 01/23/2012
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Mon, 01/23/2012
Contact Person/Corresponding Author:



Suggested Citation:
A Guide to Developing A Medical Readers' Theater (MRT) Program. POGOe - Portal of Geriatrics Online Education; 2012 Available from: https://pogoe.org/taxonomy/term/44

An Introduction to Geriatric Oncology

:  
Date Posted: 
12/31/1969
Date Reviewed/Updated for Clinical Accuracy: 
12/31/1969
Product Information
Estimated time to complete: 
1
Abstract: 

This video lecture presentation provides an introduction to geriatric oncology. It addresses the dearth of research, deficiencies and lack of evidence-based data and practice guidelines in the specialty. The interdisciplinary approach that has been developed to address the challenge of caring for older cancer patients is highlighted.

Educational objectives: 
  1. Introduce key concepts in geriatric oncology, and
  2. Review some of the challenges in management of older adults with cancer.
Date posted: 
Wed, 02/16/2011
Date Submitted or Reviewed/Updated for Clinical Accuracy: 
Wed, 02/16/2011
Contact Person/Corresponding Author:



Suggested Citation:
An Introduction to Geriatric Oncology. POGOe - Portal of Geriatrics Online Education; 2011 Available from: https://pogoe.org/taxonomy/term/44

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