Date of Award

2013

Document Type

Open Access Honors Thesis

Degree Name

Bachelor of Science (BS)

Department

Nursing

Subject Categories

Geriatric Nursing | Gerontology

Abstract

A growing body of nursing research addresses the transitional period for older adults entering long-term residential care. However, gaps exist in our understanding of nursing’s role in the transition process. Our aim is to examine the available evidence and develop a model of nursing strategies and interventions to ease the transition to long-term care. This model describes interventions that nurses can incorporate into everyday practice.

A literature review was conducted to examine the transitional care needs and interventions for older adults with a goal of developing a model addressing transitions to long-term care.

Most nursing studies provided descriptive information about patient experiences, nursing roles or long term care characteristics. Very few reports described intervention trials. Our proposed model includes domains of therapeutic communication techniques, developing quality therapeutic relationships, type/characteristics of the transition, empathic care, preparation and prevention, environment modification, and the personalization/individualization of care. The multiple domains in the model facilitate and support the delivery of individualized person-centered care in the long-term care setting. Proposed quality outcomes include measures of patient satisfaction, patient adjustment, quality of life (including function), and health status (clinical and physiologic measures).

Based on the literature review, the model identifies key issues and gaps in nursing care relevant to this patient population as they enter the long-term care setting. The model also provides a guide for future research, initially observational studies, and subsequent development and testing of innovative strategies to promote a successful transition. Further consideration is given to questions related to how the transition is facilitated in assisted living versus nursing home settings, where the transition originates, unique challenges for cognitively or mobility impaired older adults experiencing residential transitions, and how successful transitions are measured (maintenance of function, control, and independence).

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