JUNE 2019
The rain and colder-than-normal weather in Iowa this summer has not dampened the enthusiasm of the Csomay Center leadership as we made plans for the upcoming year! We are excited that the Csomay family gift has “matured” and is now providing an operational budget to resume activities that were paused when Hartford Foundation funding ended in 2015, and will allow us to add new and exciting ventures. Our plans include working in partnership with our colleagues in the College of Nursing, throughout the University of Iowa, and education, research and service leaders in communities throughout the state to advance our mission.

Collaboration with the Iowa Geriatric Education Center and Geriatric Workforce Enhancement Program (GWEP) funded by the Health Resources & Services Administration (HRSA) offers an important opportunity to expand and advance our interdisciplinary geriatric/gerontological initiatives. The focus of GWEP funding on geriatric training and practice change has cultivated many partnerships with community services, health systems, and primary care settings. In the years ahead, two important social movements are essential components of GWEP funded education and practice change initiatives for student learners, faculty, health practitioners, community service providers, and family caregivers alike. 
Age Friendly Health Systems is being advanced by the John A. Hartford Foundation and Institute for Healthcare Improvement (IHI) . Being Age Friendly includes attention to the “ 4Ms ” – What M atters to the older person; M entation, including dementia, delirium, and depression; M obility; and M edications. The IHI and Hartford Foundation set the aim that 20% of US hospitals and health systems will be Age Friendly by December 2020.
Dementia Friendly Communities is being advanced by Dementia Friendly America . Dementia Friendly communities work to support people living with dementia and their caregivers. Diverse community training and awareness materials are designed to help community members support persons with dementia to engage and thrive in day to day living while remaining in the community.
The Csomay Center is excited to promote and disseminate information about Age and Dementia Friendly approaches, and will be collaborating with the IGEC to develop new resources to assure broad dissemination and adoption in practice. We will be providing more news about our community partners and their contributions to these important initiatives in future issues of our newsletter, so please do “stay tuned,” AND get in touch if you have question or would like more information!
Gerontological Pilot Project Awards
Last year the Csomay Center collaborated with the Office of Nursing Research in a new approach that advertised all collegiate research funding that is available to faculty and students in the College of Nursing. This approach combined gerontological awards with other types of funding and used standardized methods to help streamline the application, review, and award process. We are pleased to announce gerontological pilot project awards for 2019 funded by the Csomay Center and our donors.
Jacinda Bunch, PhD, RN & Heather Dunn, PhD, RN, Post-Doctoral Fellow
Jacinda Bunch
Heather Dunn
Awarded: Woodrow W. Morris Gerontology Research Award for Faculty

Title: Rapid Response System Implementation within a Long-term Acute Care Hospital (LTACH)

Amount: $5,000

Performance Period: May 2019 – April 2020
Project Overview: The Rapid Response Team is a widely adopted patient safety program designed to assist bedside nurses in the early identification of clinically deteriorating patients to bring critical care experts and resources to support the essential care provided by the nurse at the patients’ bedside. Because the Rapid Response Team was developed for use in short-term acute care hospitals, this study examines how the strategy has been implemented in a Long Term Acute Care Hospital and is the first step in directing research toward the innovative expansion of the Rapid Response Team into diverse patient care settings. 
Claire Shaw, MSN, RN, PhD Student

Awarded: Barbara and Richard Csomay Gerontology Research Award for Students and Post-Doctoral Scholars

Title: Resistiveness in Dementia: Nurse Communication in Acute Care

Amount: $3,000

Performance Period: May 2019 – April 2020
Project Overview: Effective communication by nursing staff is critically important in preventing resistiveness to care among persons with dementia. Use of elderspeak communication (i.e. baby talk) by care staff has been found to double the probability of resistive behaviors in long-term care settings, but little is known about is effect in acute care settings. The aims of this cross-sectional study are to: 1) identify and characterize elderspeak communication when used by acute care nursing staff during hospital care to persons with dementia, and 2) determine the association between elderspeak communication and resistive behaviors among persons with dementia. This study will provide preliminary evidence for the need for an elderspeak reduction intervention in the acute care setting. 
Mayday Fund Scholar
Lynn Naked, a PhD student who was awarded the Csomay Student Award in 2018, received an additional funding award from the Mayday Scholar Fund that is offered by the National Hartford Center of Gerontological Nursing Excellence. The award required matching funds that were provided by the Csomay Center. 
Lynn Nakad, BSN-PhD Student

Awarded: Mayday Fund Scholar

Title: Attitudes of Older Persons with Chronic Low Back Pain towards Virtual Reality Distraction Therapy

Amount: $5,000 total ($2,500 matched by the Csomay Center)

Performance Period: Feb 2018 – Jan 2020
Project Overview: The Mayday award supports Naked’s ongoing research related to using virtual reality as distraction from pain. The aims of this research are to (1) describe the attitudes of older adults suffering from chronic low back pain towards Immersive Virtual Reality therapy; and (2) describe and explore if levels of perceived pain intensity and interference relate to the level of Immersive Virtual Reality treatment acceptability. 
Taking care of yourself in the heat of a Midwest summer is important – and being aware of the most common illnesses and injuries associated with summer weather is the first step in doing that.

Being outdoors with friends and families is what summer is all about – but as we age, our tolerance for the heat diminishes so here are some things to watch for: dizziness, light headedness, and a mouth that feels like cotton can be the first signs of too little fluid – grab a drink (non-alcoholic) and find some shade. With dehydration and prolonged heat exposure comes the risk of Heat Stroke .

Heat stroke is the most severe form of dehydration – internal body temperature can rise to dangerously high levels; your skin will feel hot, you stop sweating, you may have hallucinations or pass out. Preventing heat stroke is easy – drink plenty of fluids, especially water, take frequent breaks in the shade, and plan strenuous outdoor activity for early morning or late afternoon. If you or someone you are with appears to have heat stroke – get indoors, lie down, cool off with ice packs and cool cloths. If symptoms persist or worsen – call 911.

Always practice “safe sun” – wear sunscreen that protects against UVB and UVA rays, make a fashion statement with a wide-brimmed hat! Wear long sleeves and stay out of the sun at midday when the rays are strongest.

Despite your efforts, you have a sunburn – here are some things you can do to treat it
  • Drink water or juice to replace fluids lost through sweat
  • Apply a cool, wet cloth to the burned skin
  • Acetaminophen is useful in relieving discomfort
  • Apply aloe cream with emollients to soothe and soften the skin

Pesky Summertime Sting
On a beautiful morning – you decide to work in the yard when you come upon a stinging insect nest! For most people, a bee or wasp sting is just painful, but for a few – it can be life-threatening.

A few simple steps to keep yourself from being a delicious bee or wasp treat – avoid heavy perfumes or scents (especially florals), wear light-colored clothing (stinging insects are attracted to dark clothes), and protect food and sugary drinks by covering them so they don’t attract the insects.

If you do get stung – icing the wound can help and use acetaminophen for the discomfort. If you experience any of the following – go to the ER immediately – do not drive yourself! Have somebody drive or call 911:
  • Hives, itchiness, and/or swelling over large areas of your body
  • Tightness in your chest or trouble breathing
  • Swelling of the tongue or face
  • Dizziness or feeling you will pass out
The winter of 2018-2019 was long and cold – enjoy the summer with these helpful hints!

Written by N. Jane Stickney, DNP, ARNP, NP-C, College of Nursing University of Iowa
In this issue, we introduce a new standing section that we hope our readers – who are our collaborators, partners and FRIENDS – will support by sending news about their experiences, upcoming events, or other items of interest related to geriatric/ gerontological research, education, practice. We invite everyone to share statewide and national news, as well as insights, experiences or stories that help build momentum to support our mission to advance innovative practices and products that maximize optimal aging and adaptive function.
Kathleen C. “Kitty” Buckwalter, PhD, RN, FAAN , Professor Emeritus, received the Mary Starke Harper Distinguished Leader Interview award at the National Hartford Center of Gerontological Nursing Excellence conference in November 2018. This prestigious award highlights the career of a nurse whose outstanding leadership qualities and achievements serve to inspire others. We can think of no one more deserving of this honor than our own Kitty Buckwalter who has been a leader, mentor, and friend to countless individuals in her research, education, publishing and advocacy roles. She is truly an inspiration to all!! Hearty congratulations, Kitty!
Mercedes Bern-Klug, PhD, Professor of Social Work, Director of the Aging & Longevity Studies Program at University of Iowa, and member of the Csomay Center Leadership team, was highlighted in an article titled, “The Emotional Side of Care: Psychosocial Care Bridges Quality of Care and Quality of Life,” in Provider , April, 2019 ( www.providermagazine.com ) published by the American Health Care Association. Dr. Bern-Klug notes “Anything issue that comes up as a nursing issue or medical issue has psychosocial implications [that] we can respect and honor and work to enhance.” (p.20). Additional information about Dr. Bern-Klug and her many contributions to care of older people may be found here .
Telligen QIN-QIO , the Quality Improvement Network-Quality Improvement Organization for Iowa and a GWEP and Csomay Center partner, hosts a wide range of high quality educational programs to improve the quality of long-term care.  Tracy Pieters, RN, Senior Quality Improvement Facilitator , reported that webinar topics in May included “Advanced Care Planning”, “Coding Depression, the Interview and the Dementia Factor”, and “Moving from MIPS to an APM: Sharing APM Success Stories” among others. Contact Ms. Pieters at tracy.pieters@area-d.hcquis.org for more information about Telligen sponsored training or visit Telligen QIN-QIO.
Wen Liu, PhD , Assistant Professor, College of Nursing received the New Investigator award from the Gerontological Science Research Interest Group of the Midwest Nursing Research Society on March 28, 2019. Dr. Liu was also notified this May that she has been funded by the NIH/National Institute on Aging (total award $336,645 over two years) for a project titled “ Person-Centered and Task-Centered Care in Temporal Relation to Mealtime Difficulties and Food Intake for Nursing Home Residents with Dementia .” This work is foundational to the development of mealtime care programs that will help daily caregivers learn how to decrease mealtime difficulties, maximize resident’s intake, improve overall nutrition, and enhance quality of life as dementia progresses. Hearty congratulations, Dr. Liu! For more information about her work click here .
Drs. Shalome Tonnelli, Nicole Peterson, and April Prunty received an award from Academic Technologies Advisory Council ($14,472) for their project, " Engaging Nursing Students in Gerontology Utilizing Virtual Reality in the Classroom ." Drs. Tonnelli and Peterson teach undergraduate gerontological nursing clinical and didactic courses, and Dr. Prunty is the Director Simulation and Interprofessional Education and Co-Director of the Nursing Clinical Education Center. Virtual reality experiences are being introduced in the in classroom, offering students exceptional opportunities to experience the effect of common late life conditions. Hearty congratulations on this innovative work!!
Western Home Communities, Cedar Falls, hosted a campus tour and discussion on May 17 th attended by Drs. Keri Rupe, Family Nurse Practitioner program faculty; Maria Lofgren, Faculty Practice Director, Sharon Cozad, Geriatric Nurse Practitioner, and Marianne Smith, Csomay Center Director. Western Home leaders Kris Hansen, CEO; Sonya Thrall, Innovation Officer; Matt Garcia, Chief People & System Operation Officer, and Briana Hilmer, System Clinical Officer, offered a warm reception and engaging discussion related to WHC services and philosophy of senior living that was followed by discussion of doctor of nursing practice student (DNP) clinical learning and faculty practice opportunities. As a GWEP and Csomay Center Partner, WHC will lead Dementia and Age Friendly activities in the 2019 funding that introduces additional student and service learning opportunities.
University of Northern Iowa Gerontology is offering a conference, Building a Dementia Friendly Community , on July 19 th from 9 am to 3 pm. Registration is free and open to the public. Featured speakers include Donna Harvey, CEO, Northeast Iowa Area Agency on Aging; Dr. Elaine Eshbaugh, Professor of Gerontology at UNI; Sally Timmer, Program Coordinator at the Alzheimer’s Association; and Lisa Wetzel, Fund Development Coordinator at Northeast Iowa Area Agency on Aging. The event will be held at UNI, Maucher Union, 1127 W. 27 th St., Cedar Falls, Iowa. Information and registration is found here .
Assessing Heart Failure in Long-Term Care Facilities
Despite known best practices, long-term care facilities continue to experience gaps in quality of for high-risk medical conditions, including heart failure. The mean prevalence of heart failure within the long-term care setting is estimated to be 20% (17- 45%), depending on geographic location and study population. Within the long-term care setting, hospital readmission rates average 27% within the first thirty days post inpatient heart failure discharge. Individuals with heart failure who are admitted to long-term care facilities often have greater disease severity, comorbidities and distinctive vulnerabilities.
The purpose of the heart failure assessment guideline is to outline a systematic approach for the assessment of heart failure and the early recognition of symptoms of worsening heart failure in the long-term care setting, post-acute care units, and short-term rehabilitation units using taught observation skills of direct caregivers. This evidence-based practice guideline is intended for use by healthcare workers in long-term care facilities.  Written 2006; Revised 2012; 2019.

Guideline available at UIowaCsomayGeroResources.com
Leadership Team:
Marianne Smith , PhD, RN, FAAN, Director - Marianne-Smith@uiowa.edu
Keela Herr , PhD, RN, FAAN, AGSF, Co-Director - Keela-Herr@uiowa.edu
Howard Butcher , PhD, RN, College of Nursing - Howard-Butcher@uiowa.edu
Nicola Jane Stickney , DNP, ARNP, NP-C, College of Nursing Faculty Practice -
Linda Seydel , MA, LNHA, Iowa Geriatric Education Center - Linda-Seydel@uiowa.edu
Mercedes Bern-Klug , PhD, MSW, MA, Professor; Director, Aging & Longevity Studies
 Program; Hartford Faculty Scholar - Mercedes-Bern-Klug@uiowa.edu
Ryan Carnahan , PharmD, MS, BCPP, Associate Professor, Director of Graduate Studies,
 College of Public Health - Ryan-Carnahan@uiowa.edu
Ryleigh Maas , BS, Innovation Coordinator - Ryleigh-Maas@uiowa.edu
Eiko Oka , MPH, Center Coordinator - Eiko-Oka@uiowa.edu
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Resources and Tools for Quality Pain Care
Please visit GeriatricPain.org
Correction:  We apologize for our accidental omission of Oaknoll Retirement Community, Iowa City, as participant in the pilot study that evaluated the newly developed training series, Partnerships to Improve Care and Quality of Life for Persons with Dementia , that was highlighted in our December 2018 newsletter.