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Canadian Geriatrics Journal: CGJ

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https://www.readbyqxmd.com/read/28396706/a-scoping-review-of-frailty-and-acute-care-in-middle-aged-and-older-individuals-with-recommendations-for-future-research
#1
REVIEW
David B Hogan, Colleen J Maxwell, Jonathan Afilalo, Rakesh C Arora, Sean M Bagshaw, Jenny Basran, Howard Bergman, Susan E Bronskill, Caitlin A Carter, Elijah Dixon, Brenda Hemmelgarn, Kenneth Madden, Arnold Mitnitski, Darryl Rolfson, Henry T Stelfox, Helen Tam-Tham, Hannah Wunsch
There is general agreement that frailty is a state of heightened vulnerability to stressors arising from impairments in multiple systems leading to declines in homeostatic reserve and resiliency, but unresolved issues persist about its detection, underlying pathophysiology, and relationship with aging, disability, and multimorbidity. A particularly challenging area is the relationship between frailty and hospitalization. Based on the deliberations of a 2014 Canadian expert consultation meeting and a scoping review of the relevant literature between 2005 and 2015, this discussion paper presents a review of the current state of knowledge on frailty in the acute care setting, including its prevalence and ability to both predict the occurrence and outcomes of hospitalization...
March 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28396705/changing-the-impact-of-nursing-assistants-education-in-seniors-care-the-living-classroom-in-long-term-care
#2
REVIEW
Veronique M Boscart, Josie d'Avernas, Paul Brown, Marlene Raasok
BACKGROUND: Evidence-informed care to support seniors is based on strong knowledge and skills of nursing assistants (NAs). Currently, there are insufficient NAs in the workforce, and new graduates are not always attracted to nursing home (NH) sectors because of limited exposure and lack of confidence. Innovative collaborative approaches are required to prepare NAs to care for seniors. METHODS: A 2009 collaboration between a NH group and a community college resulted in the Living Classroom (LC), a collaborative approach to integrated learning where NA students, college faculty, NH teams, residents, and families engage in a culture of learning...
March 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28396704/emergency-department-stay-associated-delirium-in-older-patients
#3
Marcel Émond, David Grenier, Jacques Morin, Debra Eagles, Valérie Boucher, Natalie Le Sage, Éric Mercier, Philippe Voyer, Jacques S Lee
BACKGROUND: Caring for older patients can be challenging in the Emergency Department (ED). A > 12 hr ED stay could lead to incident episodes of delirium in those patients. The aim of this study was to assess the incidence and impacts of ED-stay associated delirium. METHODS: A historical cohort of patients who presented to a Canadian ED in 2009 and 2011 was randomly constituted. Included patients were aged ≥ 65 years old, admitted to any hospital ward, non-delirious upon arrival and had at least a 12-hour ED stay...
March 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28396703/characteristics-and-incidence-of-traumatic-brain-injury-in-older-adults-using-home-care-in-ontario-from-2003-2013
#4
Connor McGuire, Vicki L Kristman, Lynn Martin, Michel Bédard
OBJECTIVES: Describe the characteristics and determine the annual cumulative incidence of traumatic brain injury (TBI) in older adults receiving home care in Ontario from 2003 to 2013. METHODS: A retrospective cohort study of longitudinal data from the Ontario Association of Community Care Access Centers (N = 554,313). TBI, demographic variables, depression, neurological conditions, and recent falls were measured from the Resident Assessment Instrument-Home Care...
March 2017: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050225/falls-fall-related-injuries-special-interest-group-a-call-to-action
#5
Manuel Montero-Odasso, David B Hogan
No abstract text is available yet for this article.
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050224/perspectives-from-geriatric-in-patients-with-heart-failure-and-their-caregivers-on-gaps-in-care-quality
#6
Nahid Azad, G Lemay, J Li, M Benzaquen, L Khoury
BACKGROUND: Evidence indicates that care experiences for complex HF patients could be improved by simple organizational and process changes, rather than complex clinical mechanisms. This survey identifies care gaps and recommends simple changes. METHODS: The study utilized both quantitative and qualitative methods at The Ottawa Hospital, Geriatric Medical Unit during a three-month period. RESULTS: Nineteen patients (average age 85, 12 female) surveyed...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050223/geriatric-homelessness-association-with-emergency-department-utilization
#7
Ana Hategan, Daniel Tisi, Mariam Abdurrahman, James A Bourgeois
BACKGROUND: Homeless adults frequently use emergency departments (EDs), yet previous studies investigating ED utilization by the older segment received little attention. This study sought to characterize older homeless adults who utilized local urban EDs. METHODS: ED encounters at three hospitals in Hamilton (Ont.) were analyzed, and demographic and clinical characteristics of the older homeless (age > 50) vs. younger counterparts (age ≤ 50) were compared during a 24-month period...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050222/validity-reliability-and-acceptability-of-the-team-standardized-assessment-of-clinical-encounter-report
#8
Camilla L Wong, Mireille Norris, Samir S Sinha, Maria L Zorzitto, Sushma Madala, Jemila S Hamid
BACKGROUND: The Team Standardized Assessment of a Clinical Encounter Report (StACER) was designed for use in Geriatric Medicine residency programs to evaluate Communicator and Collaborator competencies. METHODS: The Team StACER was completed by two geriatricians and interdisciplinary team members based on observations during a geriatric medicine team meeting. Postgraduate trainees were recruited from July 2010-November 2013. Inter-rater reliability between two geriatricians and between all team members was determined...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050221/quality-of-dementia-care-in-the-community-identifying-key-quality-assurance-components
#9
George A Heckman, Veronique M Boscart, Bryan B Franco, Loretta Hillier, Lauren Crutchlow, Linda Lee, Frank Molnar, Dallas Seitz, Paul Stolee
BACKGROUND: Primary care-based memory clinics (PCMCs) have been established in several jurisdictions to improve the care for persons with Alzheimer's disease and related dementias. We sought to identify key quality indicators (QIs), quality improvement mechanisms, and potential barriers and facilitators to the establishment of a quality assurance framework for PCMCs. METHODS: We employed a Delphi approach to obtain consensus from PCMC clinicians and specialist physicians on QIs and quality improvement mechanisms...
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/28050220/last-issue-2016
#10
EDITORIAL
Ken Madden, Mark Rapoport, Colleen Maxwell
No abstract text is available yet for this article.
December 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27729951/mindfulness-based-cognitive-therapy-in-the-treatment-of-late-life-anxiety-and-depression-a-pilot-study
#11
Mathilde Labbé, Katerina Nikolitch, Romeo Penheiro, Marilyn Segal, Karl J Looper, Nathan Herrmann, Steven Selchen, Soham Rej
No abstract text is available yet for this article.
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27729950/prevention-of-post-operative-delirium-in-the-elderly-using-pharmacological-agents
#12
REVIEW
Patrice Tremblay, Susan Gold
INTRODUCTION: Post-operative delirium (POD) is a serious surgical complication that can cause significant morbidity and mortality. It is associated with prolonged hospital stay, delayed admission to rehabilitation programs, persistent cognitive deficits, marked health-care costs, and more. The pathophysiology is multi-factorial and not completely understood, which complicates the optimal management. Non-pharmacological measures have been the mainstay of treatment, but there has been an ongoing interest in the medical literature on the prevention of post-operative delirium using medications...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27729949/frailty-and-intellectual-and-developmental-disabilities-a-scoping-review
#13
REVIEW
Katherine McKenzie, Lynn Martin, Hélène Ouellette-Kuntz
BACKGROUND: Individuals with intellectual and developmental disabilities (IDD) are both living longer than in previous generations and experiencing premature aging. Improved understanding of frailty in this aging population may inform community supports and avoid negative outcomes. METHODS: The objective of this study was to review the literature on frailty and IDD and determine areas for future research and application. The methodological framework for a scoping review as developed by H...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27729948/care-transitions-using-narratives-to-assess-continuity-of-care-provided-to-older-patients-after-hospital-discharge
#14
Carolyn Wong, David B Hogan
BACKGROUND: A common scenario that may pose challenges to primary care providers is when an older patient has been discharged from hospital. The aim of this pilot project is to examine the experiences of patients' admission to hospital through to discharge back home, using analysis of patient narratives to inform the strengths and weaknesses of the process. METHODS: For this qualitative study, we interviewed eight subjects from the Sheldon M. Chumir Central Teaching Clinic (CTC)...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27729947/an-evaluation-of-the-decision-making-capacity-assessment-model
#15
Suzette C Brémault-Phillips, Jasneet Parmar, Steven Friesen, Laura G Rogers, Ashley Pike, Bryan Sluggett
BACKGROUND: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS: A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. RESULTS: Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes...
September 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27403215/-not-available
#16
Pierre Molin, Kenneth Rockwood
No abstract text is available yet for this article.
June 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27403214/the-new-criteria-for-alzheimer-s-disease-implications-for-geriatricians
#17
Pierre Molin, Kenneth Rockwood
Two new sets of criteria for Alzheimer's disease (AD) are now in play, including one set released in 2014, and a proposal for a "new lexicon" for how to describe the disease spectrum. A 2012 Canadian consensus conference said that to then, none of the new criteria or terminology would change primary care practice; that is still likely to be so. For dementia consultants, however, the new criteria pose challenges and offer opportunities. In general, the new criteria see an expanded role for bio-markers. Even so, the evidence base for this remains incomplete...
June 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27403213/effectiveness-of-a-core-competency-based-program-on-residents-learning-and-experience
#18
Lesley Charles, Jean Triscott, Bonnie Dobbs, Peter George Tian, Oksana Babenko
BACKGROUND: The Care of the Elderly (COE) Diploma Program is a six-to-twelve-month enhanced skills program taken after two years of core residency training in Family Medicine. In 2010, we developed and implemented a core-competency-based COE Diploma program (CC), in lieu of one based on learning objectives (LO). This study assessed the effectiveness of the core-competency-based program on residents' learning and their training experience as compared to residents trained using learning objectives...
June 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27403212/advantages-of-a-warfarin-protocol-for-long-term-care-pharmacists-a-retrospective-cohort-study
#19
Randall Sargent, Cynthia Brocklebank, Helen Tam-Tham, Tyler Williamson, Patrick Quail, Diana Turner, Neil Drummond
BACKGROUND: Warfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care. METHODS: This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio (INR) tests in the range 2...
June 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27403211/clinical-frailty-scale-in-an-acute-medicine-unit-a-simple-tool-that-predicts-length-of-stay
#20
Salina Juma, Mary-Margaret Taabazuing, Manuel Montero-Odasso
BACKGROUND: Frailty is characterized by increased vulnerability to external stressors. When frail older adults are admitted to hospital, they are at increased risk of adverse events including falls, delirium, and disability. The Clinical Frailty Scale (CFS) is a practical and efficient tool for assessing frailty; however, its ability to predict outcomes has not been well studied within the acute medical service. OBJECTIVE: To examine the CFS in elderly patients admitted to the acute medical ward and its association with length of stay...
June 2016: Canadian Geriatrics Journal: CGJ
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