Respond to discussion post below: In patients age 65 and above with a diagnosis

Respond to discussion post below:
In patients age 65 and above with a diagnosis of Alzheimer’s Disease and Related Dementias (ADRD) will the implementation of a communication tool based on Sieben’s Domain Management Model provided to nurses and caregivers improve communication and symptom management at 1 week, 2 weeks, and 1 month post discharge from hospice care. This is the proposed DNP project. The extraneous variables identified by the writer include caregiver’s time, physical and emotional well-being, financial stability, other family issues of concern and energy to manage the care of a person with ADRD at home and learning a new strategy for communication.
Alves et al. (2021) discuss the specifics of caregivers providing care for the oldest old with dementia. The study analyzed how stressors (care recipient’s condition and the caregiver’s burden), moderators (caregiving context and needs), and caregivers’ outcomes (caregiver’s health characteristics) changed over time (Alves et al. 2021). Variables listed above impacted the caregiver’s over time, in addition the author’s noted that the person receiving care also had declines in health status which in turn created further stress for the caregiver. The extraneous variables for nurse include learning the new strategy for communication, the motivation to change current practice, support from hospice for extra time necessary to teach caregivers of the new communication method. Hudson et al. (2019) addressed the role of the hospice nurse in care transitions and the unique role they play in communication among patients, caregivers and family members. The article presented some ideas of other extraneous variables that could be considered for this project including nurses serving as an intermediary to address patient-caregiver issues, acting as a neutral third party, providing emotional support for caregivers as they deal with physical changes or frustrations expressed by the patient (Hudson et al. 2019). The extraneous variables identified by the writer and in the literature are similar, but the perspective of the hospice nurse as a channel for the caregiver to either interact with the patient or the trusted support provider were not considered. Another variable that was not identified may be that the nurse sees this role as integral to their connection with the patient and family in the hospice model of family centered care.
References
Alves, S., Rabeiro, O., & Paul, C. (2019). Trajectories of informal caregiving to the oldest-old: a one-year follow-up study. Western Journal of Nursing Research 43 (5), DOI 10. 1177/0193945920954862
Hudson, J., Reblin, M., Clayton, M. F., & Ellington, L. (2019). Addressing cancer patient and caregiver role transitions during home hospice nursing care. Palliative & Supportive Care, 17(5), 523-530. https://doi.org/10.1017/S1478951518000214