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A Conceptual Framework for Understanding the Decision-making Processes of Nursing Assistants in Providing Dementia Care

CORAZZINI, KIRSTEN PhD; MCCONNELL, ELEANOR S. PhD, RN; RAPP, CARLA GENE PhD, RN; ANDERSON, RUTH A. PhD, RN

FEATURE TOPIC: EDUCATING CAREGIVERS FOR PERSON-CENTERED DEMENTIA CARE
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Our current understanding of how nursing assistants (NAs) provide unlicensed nursing care to the cognitively impaired suggests NAs make choices about how to provide care in ways that may be classified as either rational or intuitive. The degree to which either strategy is related to better care outcomes depends on the background of the NA and the management practices of the clinical leadership in the facility. Practitioners who support open, timely, and accurate communication, a reward-based administrative climate, and NA participation in care planning have the opportunity to improve NA decisions for better care outcomes for residents with dementia.

Kirsten Corazzini, PhD, is assistant professor at the School of Nursing and senior fellow in the Center for Aging and Human Development at Duke University. Her research focuses on front-line caregiver problem solving across the continuum of long-term care settings.

Eleanor S. McConnell, PhD, RN, is associate professor and director of the Gerontological Nursing Program at the School of Nursing, senior fellow in the Center for Aging and Human Development at Duke University, and clinical nurse specialist with the Durham VAMC GRECC. Her research focuses on preventing functional decline in older adults, with particular attention to the cognitively impaired.

Carla Gene Rapp, PhD, RN, is assistant professor at the School of Nursing and senior fellow in the Center for Aging and Human Development at Duke University. Her research program focuses on behavior problems in people with dementia and/or acute confusion/delirium.

Ruth A. Anderson, PhD, RN, is associate professor at the School of Nursing and director of the Leadership in Community-based Long Term Care Program at the School of Nursing and senior fellow in the Center for Aging and Human Development at Duke University. Her research focuses on the outcomes of nursing management practices in long-term care settings.

Address correspondence to: Kirsten Corazzini, PhD, Assistant Professor, Duke University School of Nursing, Duke University Medical Center, Box 3322, Durham, NC 27710. E-mail: coraz001@mc.duke.edu.

This research was supported in part by the Trajectories of Aging and Care Center at Duke University funded by the National Institute of Nursing Research (1P20NR07795-01, Elizabeth C. Clipp, PI) and the National Institute of Nursing Research (2R01NR03178094A2, Ruth A. Anderson, PI).

©2004Lippincott Williams & Wilkins, Inc.