Aim: This study aimed to explore how stroke survivors deal with stroke‐related impairments when rebuilding their lives in the community and their experiences of exercising at home.Design: An explorative and descriptive qualitative study.Methods: A purposive sample of ten stroke survivors residing at home was recruited to explore experiences of rebuilding their lives in the community and exercising at home. One focus group interview was conducted followed by semi‐structured interviews. Data were analysed using thematic analysis.Results: Three main themes were identified: “Framing exercise within the context of everyday life” describes how stroke survivors integrate exercise in everyday activities with varying success and the social importance of exercising; “Managing the challenges of physical impairment” describes the taxing undertakings in daily living, loss of concentration and identity; “Long‐term challenges of everyday life” describes how the stroke survivors manage depression and live with a sense of uncertainty.
Objective: This scoping review aims to explore and synthesize the core competencies and skills required for primary care nurses conducting comprehensive geriatric assessments. Comprehensive geriatric assessments have become integral to providing holistic, patient-centered care for older adults with complex health needs, but the specific competencies required in primary care remain underresearched. Design: The review followed Arksey and O’Malley’s five-stage scoping review framework, incorporating studies from PubMed, CINAHL, EMBASE, and the Cochrane Library. A comprehensive search was conducted from May 2014 to May 2024, and a population–concept–context (PCC) framework was used to identify relevant studies. Results: Nineteen studies met the inclusion criteria, revealing six key competency domains for nurses involved in comprehensive geriatric assessments: Clinical Assessment and Diagnostic Competencies, Care Planning and Coordination, Professional and Interpersonal Competencies, Environmental and Systemic Competencies, Technical and Procedural Competencies, and Quality Improvement and Evidence-Based Practice. These competencies are essential for providing high-quality care to older adults and supporting integrated, multidisciplinary approaches to geriatric care. Conclusions: The identified competency domains provide a structured framework that can enhance primary care nurses’ ability to deliver more effective, individualized, and coordinated care to older adults. However, the standardization of these competencies remains crucial for ensuring consistency in practice.
This narrative review examines the Comprehensive Geriatric Assessment (CGA), a multidisciplinary approach used to evaluate and manage the health of older adults. CGA has been shown to improve functional status, reduce hospital readmissions, delay institutionalization, and lower mortality. Despite these benefits, systematic implementation remains limited. Major barriers include shortages in the workforce and resources, a lack of standardized protocols, and insufficient training in geriatric competencies. These challenges leave many older adults with unmet healthcare needs, particularly in chronic disease management, functional limitations, mental health, and social support. Nurses are well positioned to address these gaps because of their expertise in patient-centered care, care coordination, and chronic disease management. Strengthening geriatric nursing education and integrating CGA into routine nursing practice can improve outcomes for the aging population. Although CGA is often associated with hospital settings, its future lies in broader application. Digital solutions scheduled health assessments, workforce planning, and community- or home-based evaluations can make CGA more accessible. Policymakers, healthcare systems, and educational institutions must work together to develop policies that embed CGA within primary healthcare.
1 August 2011 in International Journal of Older People Nursing
Background: In a changing world where populations are ageing and older people need assistance to live at home, caring for an older relative can be challenging and have various consequences for caregivers.Methods: In this cross‐sectional study, caregiver distress in six European countries—Iceland, Belgium, Finland, Germany, Italy and the Netherlands—was examined and compared. The study aimed to determine the prevalence of distress among caregivers of older people receiving home care in these six countries and identify if factors related to the older person's condition, such as health or function, predict it. The analysis drew on data collected from 2014 to 2016 for the IBenC study (Identifying Best Practices for care‐dependent elderly by Benchmarking Costs and Outcomes of Community Care), using the interRAI‐Home Care (HC) instrument. A total of 2884 home care clients > 65 years from the six countries participated in the study. Descriptive statistics indicated the characteristics of the sample, and bivariate and multivariate logistic regression models established predictive independent variables for caregiver distress.Results: The percentage of caregiver distress was highest among Icelandic caregivers (34%). In the other countries, it varied from 9% to 22% and was lowest in Finland. Caregivers of clients with signs of depression, clients who have bladder incontinence or who had stayed in hospital in the last 90 days were more likely to experience caregiver distress. Caregiver distress was more prevalent if a client was at risk of severe health decline and had increased care needs.Conclusion: Using data from interRAI‐HC assessments makes it possible to relate indications of caregiver distress to the characteristics of the older person cared for. Hence, improving their condition might have favourable effects on caregivers. Alertness to caregiver distress is crucial.