Page 121 - Encyclopedia of Nursing Research

88 n ConTInUInG CARE RETIREMEnT CoMMUnITIES

nurse responsible for those in independent throughout the aging process (Adams, 1996;
living to help with routine care activities such Lewis et al., 2006; Petit, 1994; Resnick, 1998,
C as dressing changes, administration of inject- 2003; Resnick & Spellbring, 2000; Resnick,
able medications, and health screenings. It is Wagner, & House, 2003). Studies have
these nurses who are the first response to included descriptive surveys where residents
emergencies and often the first to identify are asked about specific health behaviors such
changes in the older resident. Depending as getting vaccinations, monitoring choles-
on the CCRC, there may also be a geriat- terol and dietary fat intake, exercise activity,
ric nurse practitioner available for daytime alcohol and nicotine use, and participation in
management of acute and chronic problems health screenings including mammograms,
and a cadre of primary and specialty physi- Pap tests, stools for occult blood or prostate
cians. The availability of health care is seen examinations, or osteoporosis management.
as a major advantage to living in a CCRC, Findings have indicated that the majority of
and the focus on health promotion and dis- residents in CCRCs get yearly flu vaccines,
ease prevention is of importance to residents. have had at least one pneumonia vaccine, and
The focus on health and the maintenance approximately 61% had an up to date tetanus
of health, which is held by the residents in booster. A smaller percentage (approximately
CCRCs and supported by managers within 30%) monitored their diets. Approximately
these systems, make the CCRC a perfect envi- 50% of those living in CCRCs drink alcohol
ronment for geriatric nursing research. regularly, only a small percent use nicotine
The initial research in CCRCs focused (11%), and less than 50% exercise regularly.
on the assessment of residents before move With regard to cancer screening, approx-
in (Resnick, Russell, & Ruane, 2003) and their imately 40% to 50% of the residents get yearly
adjustment to the community once the move mammograms, 31% to 37% get Pap tests, 65% to
occurred (Petit, 1994; Resnick, 1989). With the 80% get Prostate examinations, approximately
aging of the communities and the residents, 60% have stools checked for blood yearly, and
the focus of this work has moved toward a little more than 50% monitor their skin for
learning about transitions of care within these abnormal growths regularly. overall, there is
settings (e.g., moves from independent living better participation in health promoting activ-
to assisted living or nursing home; Ashcraft, ities of older adults living in CCRCs when
owen, & Feng, 2006; Shippee, 2009; Young, compared with older adults in the community
2009). Specifically, transitions have been con- (Lewis et al., 2006; Resnick, 2003). Residents of
sidered with regard to the meaning of those CCRCs tend to continue to engage in screen-
transitions for older adults as well as the risk ing activities even when these are not recom-
factors for transitions. Transitions within the mended (Lewis et al., 2006).
CCRC setting are described by residents as In addition to a description of the health
disempowering and final and noted to cause promotion behaviors of these individuals,
a loss of social networks. Factors associated consideration has been given to factors that
with increased risk of transitions include influence the residents’ willingness to engage
depression, urinary and bowel incontinence, in screening activities. Combined qualita-
cognitive impairment, and functional disabil- tive and quantitative approaches were used
ity. The findings from these studies provide to explore this question (Resnick, 1998, 2003;
recommendations for how to help prepare Rosenberg et al., 2009). Common themes
residents in CCRCs for transitions from one were identified by open-ended interviews
level of care to another. and indicated that the common reasons for
The majority of research done in CCRCs, not engaging in specific health activities
however, is focused on health promotion were as follows: (1) never being told to by a