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Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium. In response, a dementia toolkit was developed by nurses and implemented on the unit to improve the care of patients with dementia. Findings Comparison of pre-implementation and post-implementation audit results indicated a significant improvement in all aspects of care for patients with dementia in the trauma and orthopaedics unit, as a result of the implementation of the dementia toolkit. Education and training were provided to staff on the ward to ensure the toolkit was implemented appropriately. Conclusion It is important to consider the specific needs of patients with dementia in acute care settings, not only the primary reason for their admission. The involvement and inclusion of staff in determining what change was needed on the unit, how change would be undertaken and the positive effects of change, demonstrates how action research can inform and improve clinical practice. [ABSTRACT FROM AUTHOR]

People with learning disabilities, particularly Down's syndrome, are at increased risk of dementia. At present, services and care tailored to people with both dementia and a learning disability are unsatisfactory. This article reviews the literature specific to dementia in people with learning disabilities, including: comprehensive screening, diagnosis, management, environmental considerations, end of life care and training issues for nursing staff. Recommendations for best practice and service improvement are made to improve the quality of life for individuals with dementia and learning disabilities, pre and post-diagnosis. [ABSTRACT FROM AUTHOR]

The Dementia Champions Programme was set up in NHS Dumfries and Galloway, Scotland, to equip nurses with the skills and knowledge to improve the care of people with dementia in hospital. Nurses who complete the programme are known as dementia champions. This article describes the multi-faceted, educational approach to improving the care of adults with dementia. [ABSTRACT FROM AUTHOR]

Pretibial lacerations are a common injury, particularly in older adults. Patients may present to the emergency department for treatment, be treated in GP surgeries by community nurses or they may self-treat. This article reviews the treatment options available to enable healthcare professionals to make informed decisions regarding the management of patients with such injuries. [ABSTRACT FROM AUTHOR]

Delirium is a common and under-reported problem in older adults. It can have a negative effect on patient outcomes and nurses often fail to identify it. This is the second part of an article that outlines nursing interventions based on the Roper, Logan and Tierney model of the activities of living. The first part of this article, which examined the clinical features, risk factors and assessment of delirium, was published in last week's Nursing Standard (Farley and McLafferty 2007). [ABSTRACT FROM AUTHOR]

Field research in care homes has revealed for the first time the significant contribution that registered nurses make to patient care. [ABSTRACT FROM AUTHOR]

This article examines the experiences of an older patient with, constipation to illustrate the importance of thorough assessment. The interaction between another medical condition and constipation is discussed, and indications for laxative use are outlined. The current evidence base for bowel care is limited. Tools for risk assessment are required and further research is needed to improve patient care in this area. [ABSTRACT FROM AUTHOR]

This article describes a pilot project that aimed to enhance the care of older people who dialled 999 but did not require hospital admission. The project demonstrated how intermediate care teams and the ambulance service worked in partnership to avoid unnecessary hospital admission and to improve health and social care services for this patient group. [ABSTRACT FROM AUTHOR]

Aim To investigate whether national vocational qualifications (NVQs) have the potential to improve the quality of care for vulnerable older people. Method An antecedent study was carried out by interviewing care staff in care homes to determine the process of achieving an NVQ and to identify the specific areas of enquiry. Individual face-to-face interviews were conducted with representatives of six training providers, who were contracted by a county council to provide training and assessment to care staff undertaking NVQ in Care levels 2 and 3. Face-to-face interviews were also carried out with care staff working in residential and nursing homes, registered with the training providers. Findings The majority of care staff receive some training, usually in-house, but this training is not necessarily specific to NVQ. Achieving an NVQ in Care is not dependent on the ability to demonstrate competence in all aspects of care, because there is a choice of units for which candidates provide evidence. The extent to which the knowledge and skills of care staff are assessed, and the standards of care that they provide to meet the holistic needs of residents, depend largely on the competence of the assessor. NVQ in Care levels 2 and 3 are mainly concerned with personal care needs rather than the healthcare requirements of residents. Conclusion NVQ in Care is an assessment process and not a training course leading to a qualification. However, some training providers offer a set course, while others assess competence on knowledge and skills. The unit contents of NVQ in Care levels 2 and 3 do not address the holistic needs of older people because some important aspects of care, for example, enabling clients to eat, drink and use toilet facilities, are optional. [ABSTRACT FROM AUTHOR]

Obtaining informed consent is a fundamental part of the care-giving process. Current policy documents emphasise the importance of including patients in planning their care. This article explores the concept of consent and the challenges to this concept for older people in long-term care, where consent is not a one-off event requiring a `consent form', but just one stage in the continuum of involvement for service users. At one end of the spectrum, service users may be unaware that they have a service user plan (care plan), while at the other end they may be enabled to complete an advance statement of their wishes, thus demonstrating significant involvement in planning their care. [ABSTRACT FROM AUTHOR]

Background: Accurate assessments of pain help healthcare professionals to identify its source and manage it appropriately. Pain in cognitively impaired older adults is difficult to assess and this can result in poor management and outcomes. In response to the vulnerability of this patient group, researchers have produced a variety of tools for pain assessment in cognitively impaired older adults. Conclusion: Replication research is recommended to validate further and generalise results, although there is enough evidence to support the use of direct observation of behaviour in identifying pain in this group of patients. [ABSTRACT FROM AUTHOR]

Improving the quality of care for older people has been a key aim of the NHS for many years and is an important part of the NHS Plan (DoH 2000). The National Service Framework for Older People, published in 2001, made it clear that intermediate care processes are central to the provision of quality care to this sector of the population (DoH 2001). This article describes a service model of intermediate care in one primary care trust, outlining the processes and challenges encountered in establishing this multidisciplinary cross-agency initiative. [ABSTRACT FROM AUTHOR]

Senior nurses say that older people's dignity is an issue for all health staff. While further guidance from the Department of Health is anticipated, some nurses are already innovators in this area. [ABSTRACT FROM AUTHOR]

Community matrons have a dual role in the care of people with long-term conditions: nursing and co-ordination. The aim is to manage patient care so that hospital admissions can be reduced, especially those that result from a crisis. • Community matrons make detailed assessments of their patients' health and social care needs. • They work across traditional boundaries, such as secondary care and social services. • Medication management is part of their remit. • Patients are visited and reviewed regularly. [ABSTRACT FROM AUTHOR]

Reports on the restructuring of the health service in Scotland. Improvement of local care delivery and services designed to meet the needs of an increasingly ageing population; Improvement of the health and well-being of the people; Escalation in nursing and midwifery recruitment and retention.

Jane Williams is thrilled with her new chief of service role, usually reserved for medics. She tells Robert Munro how she got there. [ABSTRACT FROM AUTHOR]

Though a common condition, chronic wound pain is poorly recognised and managed. Older people, who are the most commonly affected, can become socially isolated as a result. ▷ More than a million people in the UK have chronic wounds. ▷ Depression is common in people with chronic wound pain. ▷ Up to 50 per cent of community nurses' working time can be spent with people who have chronic leg ulcers. INSET: Treating chronic wound pain. [ABSTRACT FROM AUTHOR]

Presents various personal perceptions on the fertility treatment for post-menopausal woman in Great Britain. Advantages of older fertility; Importance of considering late fertility on the emotional and physical effect for the child; Refusal of giving fertility treatment to a post-menopausal woman; Diversion of scarce healthcare resources from more pressing areas towards enabling post-menopausal women for bearing children.

The article reflects the continuing medical care in England. An overview of the situation about the complex funding system that affect the costs of care is presented. The author emphasizes that the health and social care should be free at the point of giving care to older people. She believes that long-term care funding need to be sort out.

Comments on older people's frustrations over research findings on medical and nursing practices in Great Britain in 2004. Need to move beyond traditional research into ways to bring about changes in practice; Greater involvement of older people from black and minority ethnic communities in agenda setting and developing good practice; Implications on nurses and nursing.

Comments on the article published in "The Obeserver" depicting the life of older people. Description of a reporter dressed up in a suit designed to age the wearer; Insights learned from older people can offer a perspective on planning the kind of facilities needed for them; Creation of the suit for architects designing hospital accomodation.

Focuses on the Gerontology Practitioner Network in Wales. Involvement of older people in lobbying and disseminating best practice; Promotion of user-centered care; Consideration of older nurses' expertise and experiences; Influence on relevant health and social policy; Discussion of the single assessment process as it is being applied in Wales; Implications of the Assembly commitment to free personal care for older citizens.