Annals of Long Term Care

Best Practices in Nursing Care to Older Adults

from The Hartford Institute for Geriatric Nursing
New York University, College of Nursing

Issue Number 22, Revised 2007

Series Editor: Marie Boltz, MSN, APRN, BC, GNP
Managing Editor: Sherry A. Greenberg, MSN, APRN, BC, GNP
New York University College of Nursing

WHY: Approximately 40% of older adults suffer from complications of hospitalization. For the patient, families providea vital link between the patient and the staff. Nurses are in a unique position to work with families as partners toprovide quality care to hospitalized older adult patients. The first step in establishing this partnership is assessing thefamily’s preferences for participation in the care of the patient.

BEST PRACTICES: The Family Preference Index (FPRI) is a brief, easy to administer instrument to measure familypreferences, or family caregiver’s personal choice about providing care to their hospitalized relatives. Assessment of family preference should be supplemented with an evaluation of other factors that impact caregiving ability, including the family’s legal authority (including power of attorney status), as well as the family’s understanding of the patient’s needs, and stress level. (See Try This: Caregiver Strain Index). This information can be included in the initial psychosocial assessment and updated as needed.

TARGET POPULATION: The families of hospitalized older adults.

STRENGTHS AND LIMITATIONS: Little is known about family participation in hospital care for older adults. There is limited research and instrument development in this area. Initial qualitative study results indicate that the FPRI effectively identified caregiver preferences about providing care. However the tool’s validity and reliability has not yet been measured.

MORE ON THE TOPIC:
Best practice information on care of older adults: www.GeroNurseOnline.org.

Maslow, K., & Silverstein, N.M. (Eds). (2006). Improving hospital care for persons with dementia. NY: Springer Publishing Co, Inc.
Li, H. (2002). Family caregivers’ preferences in caring for their hospitalized elderly relatives. Geriatric Nursing, 23 (4), 204-207.

Li, H. (2005). Hospitalized elders and family caregivers: A typology of family worry.
Journal of Clinical Nursing, 14(1), 3-8.

Li, H. (2005). Identifying family care process themes in caring for their hospitalized elders. Applied Nursing Research, 18 (2), 97-101.

Li, H., Stewart, B.J., Imle, M.A., Archnold, P.G., & Felver, L. (2000). Families and hospitalized elders: A typology of family care actions. Research in Nursing and Health, 23(1), 3-16.

FAMILY PREFERENCES INDEX (FPRI)

Which of the following things would you prefer to do for your hospitalized elderly relative? CIRCLE NO or YES for each item.

Being there: No/Yes
Maintaining linkage to life outside the hospital: No/Yes
Doing enjoyable activities with my family member: No/Yes
Providing reassurance or emotional support: No/Yes
Engaging in religious practice (e.g., praying with my family member): No/Yes
Bringing and taking things and people between home and hospital (e.g., bringing in things): No/Yes
Helping with eating & drinking, moving, bathing, toileting, or dressing: No/Yes
Providing information to the health care team about my family member: No/Yes
Learning from the health care team about my family member’s care and treatment: No/Yes
Making sure that the health care team takes care of my family member’s needs: No/Yes
Participating in the medical and nursing treatments for my family member: No/Yes
Working together with the health care team to care for my family member: No/Yes
Participating in decision making about my family member’s care: No/Yes
Taking care of myself while I am at the hospital: No/Yes
Others: No/Yes

If others, write in

Li, H.