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Acute Pain Management in the Older Adult NEW!

Helps providers manage acute pain in elderly patients. Outcomes of effective management include reduced pain levels, minimization or elimination of complications of pain treatment, and increased patient satisfaction with pain management. Includes guides for baseline pain assessment, patient/family education, acute pain monitoring, and pharmacological and nonpharmacological treatments. Written 2000; Reviewed 2003; Revised 2006; 2016

Assessing Heart Failure in Long Term Care Facilities

Outlines a systematic approach for the assessment of heart failure in long term care facilities with the goal of preventing hospitalization of nursing home residents by using direct caregivers in the early identification of heart failure. Contains information on assessment methods and interventions needed to prevent unnecessary hospitalizations. Several tools are provided including the Long Term Care Heart Failure assessment tool, Heart Failure Weight assessment chart, and the NEW LEAF pocket screening tool for direct caregivers. Written 2006; Revised 2012

Bathing Persons with Dementia

Provides strategies for minimizing fear, agitation, combative behavior, and development of secondary behavioral symptoms during and/or after personal hygiene. The goal is to reduce frequency and severity of negative bathing episodes in patients with chronic dementing illness. Includes guides for personal hygiene standards for people with dementia and helpful communication techniques along with instructions for thermal bathing and towel or bed baths. Written 1995; Revised 2004; 2013

Changing the Practice of Physical Restraint Use in Acute Care

Assists nurses and other healthcare professionals in changing the practice of physical restraint use for the elderly in acute care settings to the current standard of restraint-free care. Identifies individual patient characteristics as well as characteristics of staff and facilities associated with restraint use. Provides alternative strategies and approaches to restraint-free care. Also includes a decision algorithm for behavior management and restraint-free care, as well as information on monitoring and documenting the use of physical restraints when necessary. Written 1996 (originally titled Restraints) ; Revised 2005; 2014


Provides direction for identifying risk factors, conducting appropriate assessments, and implementing effective strategies for the prevention and treatment of delirium. This guideline is intended for use by nurses and other healthcare disciplines that provide care for elderly hospitalized patients on general medical/surgical units. Some of the recommended interventions require physician management and interdisciplinary collaboration, while other interventions are independent nursing actions. Written 1999; Revised 2009; 2015

Detection of Depression in the Cognitively Intact Older Adult

Improves detection of depression in medically compromised, cognitively intact, older adults. Provides easy to use tools that can be used with limited training, making it ideal for a variety of healthcare workers and informal caregivers across settings. Contains examples of the Mini-Mental State Examination and the Short Geriatric Depression Scale. Also includes a Quick Reference Guide. Written 1998; Revised 2005; 2014

Detection of Depression in Older Adults with Dementia

Assists nurses and other healthcare professionals in a variety of settings to assess for depression in the older adult with dementia. Includes easy to administer tools including the mini-mental state examination (MMSE), the Short Geriatric Depression Scale, and the Cornell Scale for Depression in Dementia. Written 2007; Revised 2014

Elder Abuse Prevention NEW!

Provides information to facilitate assessment of older persons in domestic and institutional settings who are at risk for elder abuse and recommends interventions to reduce the incidence of mistreatment. Contains thirteen assessment tools, instruments, and forms to use in patient assessment of elder abuse. Also included is one relevant Nursing Outcome Classification (NOC), and relevant labels and definitions of NOC and Nursing Interventions. Written 2004; Revised 2010; 2017

Fall Prevention For Older Adults NEW!

Aims to describe strategies for identifying persons at risk for falling and for preventing falls in older adults, while maintaining autonomy and independence. Includes information regarding risk factors, interventions, and outcome evaluations along with assessment tools such as the Falls Screening Tool and the Performance Oriented Assessment of Gait and Balance. Written 1996; Revised 2004; 2016

Family Involvement in Care for Persons with Dementia (FIC)

Focuses on a program to involve family members in the care of their relative with dementia through partnerships with other, both formal and informal, care providers. Successful care partnerships result in the establishment of meaningful and satisfactory caregiving roles regardless of the care setting. Includes many helpful tools and guides such as the Instruments Activities of Daily Living Scale and the Physical Self-Maintenance Scale. Written 1999; Reviewed 2001; 2015

Family Preparedness and End of Life Support Before the Death of a Nursing Home Resident

Provide guidelines for end of life support of family members before the death of a nursing home resident. This guideline is intended for front-line staff (e.g., registered nurses, licensed practical nurses, care attendants, social workers, chaplains, and volunteers) who care for the elderly and provide support to the elders’ families in nursing homes. It is also intended for care managers who develop policy and procedures in nursing home settings. Written 2002; Revised 2009; 2015

Hydration Management

Helps health care providers determine adequate oral fluid intake for elders and provides strategies to maintain hydration and to prevent conditions associated with dehydration, such as acute confusion/delirium. Includes a hydration assessment form, comparison of common oral fluids chart, and more. Quick Reference Guide includes the Urine Color Chart. Written 1998; Revised 2011

Improving Medication Management for Older Adult Clients

Helps RNs, Nurse Practitioners, and Pharmacists to improve medication management practices for older adults. Older adults who take many medications are at high risk of getting sicker and losing function. Goals: To reduce inappropriate prescribing, decrease polypharmacy, avoid adverse events, and maintain function. Includes the Beers List of Potentially Inappropriate Medications, the Drug Regimen Unassisted Grading Scale, and more. Written 2004; Revised 2012

Late-Life Suicide: Secondary Prevention NEW!

Provides information that will assist the nurse or other health care provider in recognizing at-risk suicidal behavior in the elderly and providing appropriate and effective crisis intervention. The goal is to decrease the occurrence of suicide among elderly individuals who have contact with nurses or other health care providers. Includes risk factors, warning signs, and a psychosocial assessment form. Written 2002; Revised 2017

Management of Constipation

Describes strategies to reduce the frequency and severity of constipation among older adults. Is applicable to older adults who are hospitalized, residing in long-term care or skilled care facilities, or living in the community. Not intended for populations of enterally fed, paraplegic, or quadriplegic individuals. Includes the Management of Constipation Assessment Inventory, Bowel Pattern Assessment Form, Foods High in Fiber chart, and more. Written 1996; Reviewed 2001; Revised 2009

Management of Relocation in Cognitively Intact Older Adults

Provides strategies to help cognitively intact older adults plan for and adapt to relocation from one residence or home to another. Includes: risk factors indicating the need for relocation, risk factors for maladjustment after relocation, interventions for both pre-relocation and post-relocation management, assessment tools, and outcome evaluations. Written 2005; 2015

Non-Pharmacologic Management of Agitated Behaviors in Persons with Dementia

Discusses non-pharmacologic interventions to decrease the frequency of agitated behaviors, thereby supporting functional ability and enhancing quality of life for persons experiencing Alzheimer’s disease and other chronic dementing conditions. Includes examples of the Mini Mental State Examination and the Cohen-Mansfield Agitation Inventory. Written 1995; Revised 2004; 2015

Nurse Retention

Retaining expert nurses has a positive effect on quality patient care. Nurse managers are critical to promoting job satisfaction and diminishing turnovers of nurses working in their area. This administrative guideline is a helpful guide for nurse managers who are striving to improve retention of staff in various health care settings. Includes a Nursing Turnover Measurement Form, a satisfaction scale, a communication assessment questionnaire, and more. Written 2002; Revised 2010
Nursing Management of Hearing Impairment in Nursing Facility Residents

Provides guidelines for nursing care of nursing facility residents with hearing impairments. Intended for front-line nursing staff (registered nurses, licensed practical nurses, and certified nursing assistants) caring for older adults who are hearing impaired. Also useful for directors of nursing, nurse managers, and nursing faculty responsible for gerontological nursing competency evaluations and education on standards of nursing care for hearing impairment in older adults in nursing facilities. Includes detailed information on caring for hearing devices and identifying residents in need of referral for further assessment of hearing. Written 2007

Oral Hygiene Care for Functionally Dependent and Cognitively Impaired Older Adults

Provides practical information to assist healthcare providers with the provision and documentation of oral hygiene care for functionally dependent and cognitively impaired older adults to prevent plaque-related oral diseases. Includes the oral hygiene Quick Reference Guide, two assessment tools, and communication techniques for oral hygiene when working with cognitively impaired and behaviorally difficult older adults. Written 2002; Revised 2011

Persistent Pain Management

Assists nurses and other health care providers in the management of persistent pain in older adults through assessment and treatment strategies. Assessment tools include the Brief Pain Inventory, Verbal Numeric Rating Scale, and the Faces Pain Scale. Discusses pain management strategies, both non-pharmacological and pharmacologic and includes an algorithm for assessing pain in the cognitively impaired older adult. Written 2005; Revised 2015

Promoting Spirituality in the Older Adult

Provides guidelines for promoting spirituality for health care providers working with older adults in community and institutional settings. Developed from a holistic perspective that views humans as having integrated physical, emotional, social and spiritual dimensions; and alterations of well-being in one dimension affects the other dimensions. Contains assessment tools for evaluating spiritual well-being and guideline practice. Written 2004; Revised 2014

Quality Improvement in Nursing Homes

Aimed to provide knowledge and evidence-based strategies for quality and performance improvement in nursing homes. Departments can use this administrative guideline as a team to develop, define, implement, and evaluate their own quality improvement program. Includes a satisfaction with nursing home instrument, quality improvement knowledge assessment test, and more. Written 2003. Written 2003; Revised 2012; 2015


Assists formal caregivers of older adults with dementia in dealing with problem wandering behavior. Includes five tools to assess risk of wandering behavior, including the Revised Algase Wandering Scale and the Memory and Behavior Problems Checklist. Interventions include environmental modifications, physical and psychosocial interventions, technology and safety information and caregiver support and education tools including a consumer information sheet. Written 2002; Revised 2008; 2014

Wheelchair Biking for the Treatment of Depression

Introduces a specific recreation therapy program, wheelchair biking, for the treatment of depression in older adults with and without cognitive impairments. The goal is to reduce depressive moods in older adults and to provide a complimentary or alternative treatment to medications. Included is the Geriatric Depression Scale. Provides information on the steps for setting up a program, including Duet wheelchair bike purchase information and selection of residents to participate. Written 2003; Revised 2010