Evidence-Based Protocols for Managing Wandering Behaviors

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"Winner of an AJN Book of the Year Award!

Designated a Doody's Core Title!

I have not seen a book that does a better job with synthesis or provision of good concise information to those in need. (3 Stars)—Doody's Book Review Service

Wandering behaviors are among the most frequent, problematic, and dangerous conditions associated with dementia and a continual challenge in health care and the community. Strongly research-based, this book presents and analyzes the latest research on wandering from the clinical, health care management, and policy literature and offers practical assessment and management tools. Nurses, physicians, gerontologists and others address the range of wandering behaviors of patients with Alzheimer's and other dementias, including prevention of elopement, getting lost, falls, fractures, and the subsequent need for extended nursing home or other supervised care that may result. The book places special emphasis on the difficult and stressful problems of daily patient care, improving safety for those with cognitive impairments, and enabling those with dementia to remain independent longer.

This book is for all caregivers intent on improving care for the nearly 5 million Americans who are at risk.

Key Features of this book:

• Offers practical tools for measuring and assessing wandering
• Emphasizes difficult and stressful daily problems of patient care
• Assesses medication and nonpharmacological interventions
• Describes the Alzheimer's Association's Safe Return? Program
• Weighs environmental design factors that influence wandering behaviors

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Editorial Reviews

Doody's Review Service
Reviewer: Donna Marie Minner, BSN, RN (University of Missouri-Columbia)
Description: This is a well organized synthesis of research, best practice, and application for dealing with wandering behaviors of cognitively impaired elders.
Purpose: The purpose is to provide information to clinicians who face the day-to-day challenges of caring for persons who wander. The book succeeds in meeting these objectives through concise summaries of the literature along with practical tools and best practice examples. For those who care for frail elderly who wander, this book should serve as a great resource and ready handbook.
Audience: While written mainly for gerontologists and nurses, this book can be used for teaching all staff members cause, effect, and interventions that are appropriate for those who wander. As a long-term care nurse and consultant/research nurse for many years, I feel this book can make an important contribution for staff who struggle with these behaviors on a daily basis. I know that I will certainly carry and reference it in my own work. Both editors have extensive backgrounds in quality care of frail elders and the recognition of their needs for autonomy and safety.
Features: One of the best features of this book is its organization. It is laid out logically taking readers through the basic constructs, the assessment process, issues associated with wandering, appropriate interventions, and future directions for research. One of the most critical problems in some care venues today is the loss of the nursing process and a tendency to intervene without assessment. While I am not familiar with all of the authors, many are recognized expert clinicians and researchers in the field of gerontology. This book highlights the importance of good assessment or root cause analysis in identification of cause that leads to treatment. The one concern I have is the continued use of the phrases "behavior management" and "behavior problems" in the light of Donna Algase's research into need-based behavior. The words we use influence those we teach and those words create an unequal relationship, giving the impression that behaviors are the problem rather than the best communication possible of a need or problem.
Assessment: This book contains the components necessary for helping clinicians through the process of understanding, assessing, and intervening in wandering behaviors. With this compilation of research, tools, and practice, caregivers should be able to improve day-to-day care through better understanding and increased knowledge of why wandering occurs and how best to intervene. I have not seen a book that does a better job with synthesis or provision of good concise information to those in need.
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Product Details

  • ISBN-13: 9780826163653
  • Publisher: Springer Publishing Company, Incorporated
  • Publication date: 7/12/2007
  • Pages: 482
  • Product dimensions: 6.00 (w) x 9.00 (h) x 0.97 (d)

Meet the Author

Audrey L. Nelson, PhD, RN, FAAN, is Director of the Veterans Administration Patient Safety Research Center and has more than 28 years of experience in nursing. She currently serves as the Associate Chief of Nursing Service for Research at the Tampa VA and Director of the Tampa Patient Safety Center of Inquiry. Dr. Nelson is Associate Director of Clinical Research at the University of South Florida College of Nursing and is a Research Professor in the Colleges of Public Health and Engineering. She is a national leader in patient safety and has established and chairs the International Research Consortium on Wandering. In 2005, Dr. Nelson was awarded the John Eisenberg Award for Lifetime Achievements in Patient Safety and Quality. Dr Nelson has expertise in research methods, wandering/elopement, safe patient handling and movement, wheelchair-related falls, and patient safety technology. She has had studies funded by Veterans Health Administration, VA Health Services Research & Development and VA Rehabilitation Research and Development, and the Agency for Healthcare Research Quality (AHRQ).

Donna L. Algase, PhD, RN, FAAN, FGSA, is the Josephine M. Sana Collegiate Professor of Nursing at the School of Nursing, University of Michigan, founding Director of the Center of Frail and Vulnerable Elders, and Director of the Intervention Development and Measurement Core of the Michigan Center for Health Interventions. Her research program focuses on dementia-related behaviors with specific emphasis on the phenomenon of wandering and models to quantify and explain it. Dr. Algase has been awarded more than $6.5M in research grants from the Alzheimer's Association, the National Institutes of Aging and Nursing Research, and other foundations. Her research has resulted in numerous publications, national and international presentations and consultations, and leadership of the Need-driven Dementia-compromised Behavior Collaborative Research Group. Her accomplishments also include development of multiple research instruments to measure wandering and other dementia-related behaviors and concepts including the Algase Wandering Scale, the Wayfinding Effectiveness Scale, the Ambiance Scale, and others.

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Table of Contents




List of Figures

List of Tables

• Wandering Definitions and Terms, Donna L. Algase, D. Helen Moore, Deborah Gavin-Dreschnack, and Carla VandeWeerd
• Theoretical Models of Wandering, Donna L. Algase, Lan Yao, Cynthia A. Beel-Bates, and Jun-Ah Song
• Epidemiology of Wandering, Ladislav Volicer
• Neuropsychological Correlates of Wandering, Cheryl A. Luis and Lisa M. Brown

• Assessment of Wandering Behaviors, Donna L. Algase

• Impact of Wandering on Functional Status, Elizabeth R.A. Beattie and Cynthia A. Beel-Bates
• Caregiver Issues Associated with Wandering, Elizabeth A. Perkins, Nancy Lynn, and William E. Haley
• Cultural Issues Associated with Wandering, Inez Joseph and Gwi-Ryung Son Hong
• Root Cause Analysis of Reported Wandering Adverse Events in the Veterans Health Administration, Joseph M. DeRosier, Lesley Taylor, James Turner, and James P. Bagian
• Getting Lost: Antecedents, Wandering Behavior, and Search Strategies, Meredeth A. Rowe and Andrea J. Pe Benito

• Behavior Management of Wandering Behavior: Staff Training Issues, Lawrence Schonfeld, Lisa M. Brown, and Victor A. Molinari
• Pharmacological Interventions Associated with Wandering, Stephen Charles Castle and Michelle K. Rutledge
• The Alzheimer's Association's Safe Return® Program for Persons Who Wander, Elizabeth Bass, Meredeth A. Rowe, and Monica Moreno
• A Home Safety Program for Community-Based Wanderers: Outcomes from the Veterans Home Safety Project,
Kathy J. Horvath, Rose M. Harvey, and Scott A. Trudeau

• Technologies to Manage Wandering, William D. Kearns and James L. Fozard
• Environmental Design, Bettye Rose Connell and Margaret P. Calkins
• Evidence-Based Practice Prools for Wandering, Elizabeth R.A. Beattie and Laura M. Struble

• A Research Agenda to Build the Science Associated with Wandering, Audrey L. Nelson and Donna L. Algase


Appendix A: Compendium of Wandering-Related Terms and Definitions

Appendix B: Measurement Tools for Wandering

Appendix C: Wandering Resources


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