The purpose of this study was to explore eating, feeding and nutrition among stroke patients in nursing homes as described by their nurses and by assessments. Registered Nurses were interviewed about an individual stroke patient's state of health, care needs and nursing care received and nursing records were reviewed. Information on eating, feeding and nutrition was extracted from the interviews and nursing records. A comprehensive instrument, the Resident Assessment Instrument, was also used to assess these patients' state of health. The domains of eating, feeding and nutrition were focused on in this study. Manifest content analysis was used. The results showed that more than 80% of the stroke patients in nursing homes were assessed as having some sort of dependence in eating. According to the Registered Nurses, 22 out of 40 patients demonstrated different eating disabilities. The number of eating disabilities in individual patients ranged from 1 to 7, which emphasized the complexity of eating disabilities in stroke patients. Dysphagia was reported in almost one-fourth of the patients and 30% were described and/or assessed as having a poor food intake or poor appetite. The Registered Nurses' descriptions of the eating disabilities, nutritional problems and their care were often vague and unspecific. Only six weights were documented in the nursing records and there were no nutritional records. The findings highlight the importance of making careful observations and assessments, and of maintaining documentation about eating and nutrition early after a patient's arrival in the nursing home to enable appropriate care and promotion of health.

The dearth of evidence-based interventions available to rehabilitate bladder function following stroke means that stroke nursing practice is an experience-based endeavour. This study explains the nurses' focus on containment and social continence and highlights the need to systematically assess stroke survivors' bladder rehabilitation needs, identify types of urinary incontinence and adopt appropriate urinary continence promoting practices.

Registered nurses working in nursing homes often care for stroke patients with impaired cognition and mood disorders. Understanding the behaviour of these patients often puts great demands on nurses. This study illuminates registered nurses' descriptions and experiences of stroke patients and the nursing care given in nursing homes, with a focus on cognition and mood. Registered nurses responsible for the care of stroke patients in nursing homes were asked to describe the individual patient's state of health and the nursing care given. Patients' cognition and mood have been selected for this article. A qualitative content analysis was used to group the text into categories. Registered nurses' descriptions showed great complexity and variation in patients' disabilities, as well as uncertainty about understanding these patients and the appropriate nursing care. Registered nurses described the need for further education in stroke care, and adequate resources for patient activity training, as well as meeting patients' psychosocial and communicative needs.

Urinary incontinence is one of the most common and distressing of the conditions experienced by older people. It is not just associated with physical and cognitive frailty but also features significantly in the fit community living population. Urinary incontinence is known to be hidden and under-reported. Yet the needs of older people across the globe in relation to urinary incontinence will increase with the changing demography. Palliative strategies to contain urinary incontinence predominate in practice, although the reasons for this are not fully understood. Conservative approaches including lifestyle adjustments and behavioural therapies form the mainstay of active continence promotion but their routine use by nurses working with older people seems to be minimal. Promoting continence with older people is an area of practice long overdue for significant and sustainable practice development.

It is important to secure continuing adequate care and rehabilitation for elderly severely impaired stroke patients being discharged early from acute care hospitals.

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