Professor Receives Fellowship to Develop Better Oral Nursing Care for Elders with Dementia
April 27, 2009
Rita Jablonski, assistant professor of nursing in Penn State’s School of Nursing, is the recipient of a Brookdale Leadership in Aging fellowship. Jablonski is only the third nurse to receive the fellowship since the Brookdale Foundation was established in 1985; most recipients have been medical doctors or basic scientists.
Beginning in July, she will spend two years researching ways to improve nurses’ provision of mouth care to people with dementia who resist care.
“People with Alzheimer’s disease and other forms of dementia often resist receiving daily care,” says Jablonski. “This is partially due to the nature of these diseases; people with dementia commonly misinterpret everyday interactions as threats instead of caregiving activities. Furthermore, nurses may unknowingly cause resistance through their own behavior. Over the years, I’ve seen various caregiving approaches to patients with dementia, and many tended to do more harm than good.”
Jablonski will be working in rural nursing homes in Pennsylvania. To prevent and minimize mouth care–resistant behavior, she will teach nurses principles of self-efficacy—that is, helping nurses become confident in their abilities.
Jablonski is primarily concerned with oral care, such as routine teeth brushing.
“Medicare and Medicaid do not routinely pay for preventive oral care such as teeth cleaning,” says Jablonski. “If elders do not get their teeth brushed, they can develop plaque, which progresses to gum disease. The gum disease can cause pain, place an elder at risk for pneumonia, and worsen chronic conditions such as diabetes.”
What makes the situation worse is that patients with dementia may not verbally communicate the presence of pain. Instead, they may resist mouth care if it is uncomfortable, and this will decrease their chances of receiving the routine nursing care that will ultimately make them healthier.
Jablonski has been working in nursing homes for over twenty years, taking mental note of unsuccessful caregiving practices she has seen, most of which resulted from inadequate caregiver education and lack of understanding about dementia. Her experience and her willingness to try to see the world through the eyes of someone with dementia has motivated her to develop better nursing care approaches.
Jablonski plans on continuing to teach at least one course each academic year during her fellowship. “There’s no better way to be a leader in aging than by sharing with my students cutting-edge knowledge about policy and practice informed by research,” she says. “They’ll be the ones working with older adults in a few years.”
Her mentor during the fellowship will be Ann Kolanowski, Elouise Ross Eberly Professor in the School of Nursing.
The goal of the Brookdale Leadership in Aging Fellowship Program is to “train the next generation of experts in geriatrics and gerontology.” It awards funds to junior academicians, up to $125,000 annually, to establish themselves as geriatric researchers.
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