Karen Zulkowski, DNS, RN, CWS, is Associate Professor, College of Nursing, Montana State University Bozeman, Bozeman, MT. Elizabeth A. Ayello, PhD, RN, APRN,BC, CWOCN, FAPWCA, FAAN, is a faculty member, Excelsior College School of Nursing, Albany, NY, and Senior Adviser, The John A. Hartford Institute for Geriatric Nursing, New York, NY. Sharon Wexler, MA, RN, CNA, BC, is Nursing Research Specialist, New York Hospital Queens, Flushing, NY, and Doctoral Candidate, New York University College of Nursing.
Submitted April 25, 2006; accepted in revised form August 3, 2006.