Associations between caregiving, social support, and well-being among parents of children with childhood apraxia of speech.

This study tested a path model that examined the impact of contextual caregiving variables (i.e., severity of child's symptoms, caregiving demands, and perceived caregiving) and different forms of received romantic partner social support (i.e., emotional, esteem, network, tangible, and information) on depressive and somatic symptoms among parents with a child diagnosed with childhood apraxia of speech (CAS), a severe childhood speech disorder. In total, 169 parents of a child with CAS participated in this study. Results provide some support for one stress process model of caregiving, which further highlights the need to look at relational variables as mediators between contextual stressors and health outcomes in caregiving contexts.

[Dementia and the gestures surrounding meals]. / Démences et gestuelle de la prise des repas.

The nursing research project "Praxalim" was initiated by a nursing team. Confronted with Alzheimer's disease and related illnesses, the nursing staff wanted to work on help with daily living tasks and in particular meals.

Revisión de conocimientos para cuidar a pacientes con problemas neurológicos / Review of the knowledge on care of patients with neurological problems

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[Autism and nursing. Facilitated communication: significance of and use to the nursing of persons with autism with severe disabilities of action and communication]. / Die Gestützte Kommunikation: Bedeutung und Anwendung in der Pflege von autistischen Menschen mit schweren Handlungs- und Kommunikationsstörungen.

The following article searches for evidence based nursing measures in case of severe disabilities of action and communication, if criteria of autism can be applied. The effects of the impairments on daily life are described in typical situations. The caregivers of the persons affected must perform a constant and very demanding care, if they want to cope with daily life and strive for a meaningful social existence. The given situation prompted the question how professional caregivers take care of individuals with autism, who are both apraxic and aphasic. The central characteristics of autism are described on the basis of the International Classification of Diseases (ICD), and specific therapeutic interventions are named. But neither autism therapies nor a literature search concerning nursing concepts for apraxic and aphasic persons could answer the above question. Hence, the author investigates the nursing relevance of the pedagogical concept of Facilitated Communication (FC). That widespread but scientifically, controversially discussed method is applied to persons with autism who are apraxic and unable to speak and communicate with gestures or facial expressions. Practical examples of daily life give a first impression of the use of Facilitated Communication. Subsequently the historical development, the target group and central elements of Facilitated Communication, as communication assessment and well-directed physical, verbal and emotional support, are described. The depiction of the concept FC ends with the discussion regarding the validity of the method. If validity of Facilitated Communication is discussed the term apraxia is frequently mentioned. In order to better understand the nature of apraxic disorders and to validate Facilitated Communication more appropriately, this method is brought into relationship with knowledge of medicine and physiotherapy. Basic Stimulation and the concept of Affolter resemble Facilitated Communication. They focus similar target groups and work likewise with physical contact; therefore differences and equivalencies are discussed. Finally, the possible application of Facilitated Communication in nursing is presented in the context of the preceding investigations. The "Action Oriented Care" of Wittneben forms the frame to the exemplary development of a nursing assessment and description of nursing measures for persons with autism and severe disabilities of action and communication. A representation of relevant evaluation criteria permits the nurses to estimate the effectiveness of their care and gives thus reference points, whether the practiced care actually helps the persons who are affected.

Restoring dressing independence in persons with Alzheimer's disease: a pilot study.

PURPOSE: Well meaning nursing facility staff may compromise the independence of older adults with dementia by performing activities of daily living for residents. We assessed the impact of teaching certified nursing assistants (CNAs) to use a graduated prompting procedure to increase dressing independence of persons with dementia. DESIGN AND METHODS: This study was conducted in a seven-bed dementia care unit. Three residents and two CNAs participated in the study. We used a repeated-measures experimental design to evaluate the effect of a training workshop for CNAs on a strategy for increasing resident engagement in self-care activities. RESULTS: During a series of baseline observations, we found that CNAs typically dressed residents with minimal resident involvement. Results showed that, following the training workshop for CNAs, resident independence in dressing increased and range of motion improved. IMPLICATIONS: CNAs can provide restorative care that increases dressing independence and range of motion of older adults with dementia.

Use of a content methodology process to enhance feeding abilities threatened by ideational apraxia in people with Alzheimer's-type dementia.

Self-feeding behavior is often the first of a chain of self-maintenance skills to deteriorate in people with Alzheimer's-type dementia and is a major determinant of institutionalization. Moreover, nurses working in geriatric settings report the feeding of patients as a most difficult management problem. Of the various features of Alzheimer's-type dementia that can affect a person's ability to feed him- or herself, ideational apraxia can explain the loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects necessary for feeding. In this article, a systematic process is used to review the research literature to develop substantive content for nurses caring for people with feeding problems related to ideational apraxia. Ideational apraxia is a condition in which an individual is unable to plan movement related to an object because he or she has lost the perception of the object's purpose. The specific abilities necessary for feeding that are threatened by ideational apraxia are identified. A tool to assess these abilities is described, and nursing interventions aimed at enhancing or preserving existing abilities, preventing excess disability, or compensating for lost abilities are presented.

Perceptual dysfunction: nursing assessment and management.

Perceptual dysfunction is a complex problem and can be a serious barrier to the patient's recovery of independence. Nurses play a significant role in the identification of a possible perceptual deficit and in the use of nursing interventions that complement and are coordinated with the work of the occupational therapist. Four common categories of perceptual dysfunction are identified. One-sided neglect and apraxia are emphasized and specific assessment data and nursing interventions for these two problems are discussed. Agnosia and visual-spatial relationship problems are described briefly. The related problem of visual deficits is outlined and discussed with reference to perceptual dysfunction.