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American Journal of Alzheimer's Disease and Other Dementias®, Vol. 22, No. 5, 369-377 (2007)
DOI: 10.1177/1533317507305593
© 2007 SAGE Publications

Provision of Morning Care to Nursing Home Residents With Dementia: Opportunity for Improvement?

Philip D. Sloane, MD, MPH

Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina, psloane{at}med.unc.edu, Department of Family Medicine, University of North Carolina, Chapel Hill, psloane{at}med.unc.edu

Lois L. Miller, PhD, RN

School of Nursing, Oregon Health & Science University, Portland, Oregon

C. Madeline Mitchell, MURP

Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, North Carolina

Joanne Rader, MN, RN

School of Nursing, Oregon Health & Science University, Portland, Oregon

Kristen Swafford, MS, RN

School of Nursing, Oregon Health & Science University, Portland, Oregon

Shirin O. Hiatt, MPH, RN

School of Nursing, Oregon Health & Science University, Portland, Oregon

Significant contact between nursing staff and nursing home residents with dementia occurs during assistance with activities of daily living during morning care; however, the content and process of morning care have received little attention in the scientific literature. To better understand the morning care process and its role in generation of pain symptoms, 51 videotaped episodes of morning care involving 17 nursing home residents from 3 long-term care facilities were coded and analyzed; each resident had a diagnosis of dementia and concern about possible pain during assistance with activities of daily living. The typical morning care episode involved performance of multiple activities of daily living during a short period of time, during which pain stimulation and expression occurred frequently. Much could be done to make morning care more an activity to be enjoyed rather than a task to be completed.

Key Words: pain • activities of daily living • morning care


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