Nursing Older People: Practice Questions

The Practice Question series is written by members of the BGS Nurses and AHPs Council and published by Nursing Older People, a journal for professionals working in gerontological care. The questions explore a range of issues in the care of older people with the aim of providing practical, evidence-based answers that can be used by nurses and AHPs in all settings. You must be a member to view these resources.

How can further deconditioning be prevented in older people after COVID-19?

Nurses can help counter the physical and cognitive decline of older people caused by their isolation during the pandemic.

How can I support rehabilitation of care home residents after COVID-19?

Rehabilitation for people in long-term care can improve function and counter lockdown effects, and nurses have a key role to play in this.

How do I use the Clinical Frailty Scale?

Frailty identification instruments improve patient outcomes, enhance care and help plan for future needs.

How do I manage delirium in older people with COVID-19?

Delirium is now recognised as a common symptom of coronavirus, and older people living in long-term care facilities are at higher risk, especially those with dementia.

Simulated practice to improve care

This Practice Question has been published with the kind permission of the Royal College of Nursing. Could simulated practice with registered nurses improve the delivery of healthcare for older people in hospital?

Productive practice in health care

Productive working is often associated with manufacturing, where being productive results in producing items. Many of the techniques that can be used to assess and improve productivity originated in the car manufacturing industry.

Helping older people in our care home stay connected

Joint activities such as art, sewing, knitting, cooking or growing plants help relationships grow between the generations. This Practice Question has been published with the kind permission of the Royal College of Nursing.

Collaborative working with patients and their families

‘Person-centred care’ is a much-used phrase in nursing. According to the Nursing and Midwifery Council (2010), nurses must ‘be responsible and accountable for safe, compassionate, person-centred, evidence-based nursing’.

Clinical guidelines

What is critical thinking and how can it help me to be a better nurse?

Decision-making is a critical element of nursing where evidence and education both play a crucial role.

Spirituality - How should we assess the spiritual needs of our patients?

While it may be unrealistic to celebrate every significant day for every patient, we know that assessment of a person’s spiritual needs should be an integral part of our professional assessment.

Mental health nurses and older patients’ physical health needs

Physical health problems, particularly chronic health problems such as obesity, diabetes and smoking-related illnesses, are more common in people with long-term mental illness.

Improving care for older surgical patients

How can I provide person-centred care for older people living with frailty?

As frailty progresses, individuals become more susceptible to developing conditions known as frailty syndromes, which may include multiple falls, acute confusion/delirium, sudden loss of mobility and incontinence.

Safe Nurse Staffing Levels on Wards

Can it be used by nurses to determine whether staffing levels are safe on their wards?

Good practice guide

Telehealth and ‘assistive technology’ What it means and impact on care

Assistive technology or telehealth, is designed to support people in their own homes. Telehealth is the remote exchange of data between a patient at home and clinicians to assist in diagnosis and monitoring.

How would I recognise if someone with dementia was experiencing anxiety or depression?

Depression and anxiety can severely affect the quality of life of those living with dementia but the overlap of symptoms can present challenges.

Frail older people and emergency care

This case study illustrates some best practice solutions to support frail patients, carers and families if admitted to emergency care.

How can advance care planning improve end of life care for nursing home residents?

Advance care planning (ACP) is a process of engagement with the person, their family and a member of the nursing home team which promotes inclusivity and personalisation.

How do I care for a person with a stoma and dementia?

Symptoms associated with dementia can add to the challenges of managing a stoma and this resource offers some practical tips.

Benzodiazepines and falls risk

Falls are a frequent and frightening issue for patients and staff, and they have physical and psychological consequences for individuals and society. They are costly in human and financial terms (National Institute for Health and Clinical ExceIlence 2004).

Improving the care of patients with dementia in an acute care setting

General hospitals are designed to deliver safe, effective and often highly technological care. For people with dementia, however, these unfamiliar clinical environments can be frightening, disorientating and a threat to independence and wellbeing.

Good practice guide

Mental capacity in the face of need for essential treatment

There is lack of clarity in the terminology used, and the difference between ‘holding’ and ‘restraint’. This presents a legal and professional dilemma for nurses.

Good practice guide

I often suspect that an older person is depressed, but I cannot persuade colleagues to consider this diagnosis.

Nurses frequently complain to me that when they think an older patient might have depression they have difficulty in convincing colleagues to take action. This could be because of the under-recognition of depression in old age, and also the way in which nurses articulate their concerns.

Sexual Intimacy in Residential Care

In 2008 a letter was sent to 826 residential homes in one state in Australia asking them what information was available that addressed issues of intimacy and sexuality.