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Hospital elder life program

Benjamin P d'S Murphy, Michelle M Dowsey, Peter F M Choong
BACKGROUND: Elective total hip arthroplasty (THA) and total knee arthroplasty (TKA) are effective options for the management of osteoarthritis that has not responded to conservative therapy, and they are increasing in utilization worldwide. Therefore, we sought to investigate how older age influences the outcomes of THA and TKA through a review of the current literature. METHODS: The Embase and MEDLINE databases were examined for relevant studies that assessed the role of older age in determining the outcomes of THA and TKA...
February 2018: JBJS Reviews
Sharon K Inouye
This article is based on the M. Powell Lawton Award Lecture that I delivered at the 2016 Gerontological Society of America Annual Meeting. I provide an overview of my journey in geriatric medicine and delirium research. I created new measures, including the Confusion Assessment Method, for identification of delirium; conceptualized a multifactorial risk model; and developed and tested intervention strategies for delirium prevention. The Hospital Elder Life Program arose from this work. In addition, like Dr...
February 23, 2018: Journal of the American Geriatrics Society
Konstantinos I Alexiou, Andreas Roushias, Sokratis E Varitimidis, Konstantinos N Malizos
Fractures due to fragility of the bone around the hip joint have become a major public health issue, presenting with an increasing incidence due to the growth of the elderly population. The purpose of this review was to evaluate the impact of hip fractures on the quality of life (QoL), health status (HS), functioning, and psychological parameters, and factors influencing the outcome and the appropriate interventions for improvement of elderly patients. A systematic electronic search of the relevant literature was carried out using the CINAHL, Cochrane, EMBASE, Medline (OvidSP), and PubMed databases spanning the time period from their establishment up to January 2017...
2018: Clinical Interventions in Aging
Adrienne M Young, Alison M Mudge, Merrilyn D Banks, Lauren Rogers, Kristen Demedio, Elisabeth Isenring
AIM: Nutritional decline during and after acute hospitalisation is common amongst older people. This quality improvement initiative aimed to introduce a dietitian-led discharge planning and follow-up program (Hospital to Home Outreach for Malnourished Elders, HHOME) at two hospitals within usual resources to improve nutritional and functional recovery. METHODS: Prospective pre-post evaluation design was used. Medical patients aged 65+ years at-risk of malnutrition and discharged to independent living were eligible...
February 2, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
Amedeo Zurlo, Giovanni Zuliani
Current demographic and epidemiological trends highlight a growing task in surgical departments by elderly patients, characterized by high prevalence of comorbidity, complexity, and functional disability. Of consequence, discharge of an elderly patient must be considered in a new cultural perspective and should be imagined as a well-structured process starting from admission to surgical department and finishing with the patient discharge in a setting able to support her/him in the best possible way. The lack of a suitable discharge planning and of a proper transition program in the elderly subjects increases the risk of quick re-admission and may negatively affect the functional and the status quality of life of patients and caregivers...
January 8, 2018: Aging Clinical and Experimental Research
Wing-Hoi Cheung, Wan-Yiu Shen, David Lok-Kwan Dai, Kin Bong Lee, Tracy Y Zhu, Ronald Man-Yeung Wong, Kwok-Sui Leung
OBJECTIVE: To investigate the effectiveness and cost of an 18-month multi-disciplinary Comprehensive Fragility Fracture Management Program (CFFMP) for fragility hip fracture patients. DESIGN: Prospective cohort study. PATIENTS: Elderly patients with hip fracture were recruited at their first postoperative follow-up in 2 district hospitals. The intervention group comprised patients from the hospital undergoing CFFMP, and the control group comprised patients from another hospital undergoing conventional care...
December 20, 2017: Journal of Rehabilitation Medicine
Marie Perier-Muzet, Elodie Gatt, Julien Péron, Claire Falandry, Mona Amini-Adlé, Luc Thomas, Stephane Dalle, Amelie Boespflug
Importance: Melanoma treatment has been revolutionized with the development of immune-based therapies that offer durable clinical responses in a subset of patients. Clinical outcomes after treatment by immunotherapy can be influenced by the host's immune system. The immune system is modified with age by age-related immune dysfunction. Objective: To evaluate if age influences clinical outcome and immune adverse events in patients treated by immunotherapy for metastatic melanoma...
January 1, 2018: JAMA Dermatology
Siddareddygari Velayudha Reddy, Jawaharlal Narayanasa Irkal, Ananthapuram Srinivasamurthy
Postoperative delirium (POD) represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD...
July 2017: Journal of Anaesthesiology, Clinical Pharmacology
Murielle Bochud, Christine Currat, Laurence Chapatte, Cindy Roth, Vincent Mooser
AIMS: We aimed to evaluate the interest of adult inpatients and selected outpatients in engaging in a large, real-life, hospital-based, genomic medicine research project and in receiving clinically actionable incidental findings. METHODS: Within the framework of the cross-sectional Institutional Biobank of Lausanne, Switzerland, a total of 25721 patients of the CHUV University Hospital were systematically invited to grant researchers access to their biomedical data and to donate blood for future analyses, including whole-genome sequencing...
October 24, 2017: Swiss Medical Weekly
Bertrand Guidet, Guillaume Leblanc, Tabassome Simon, Maguy Woimant, Jean-Pierre Quenot, Olivier Ganansia, Maxime Maignan, Youri Yordanov, Samuel Delerme, Benoit Doumenc, Muriel Fartoukh, Pierre Charestan, Pauline Trognon, Bertrand Galichon, Nicolas Javaud, Anabela Patzak, Maïté Garrouste-Orgeas, Caroline Thomas, Sylvie Azerad, Dominique Pateron, Ariane Boumendil
Importance: The high mortality rate in critically ill elderly patients has led to questioning of the beneficial effect of intensive care unit (ICU) admission and to a variable ICU use among this population. Objective: To determine whether a recommendation for systematic ICU admission in critically ill elderly patients reduces 6-month mortality compared with usual practice. Design, Setting, and Participants: Multicenter, cluster-randomized clinical trial of 3037 critically ill patients aged 75 years or older, free of cancer, with preserved functional status (Index of Independence in Activities of Daily Living ≥4) and nutritional status (absence of cachexia) who arrived at the emergency department of one of 24 hospitals in France between January 2012 and April 2015 and were followed up until November 2015...
October 17, 2017: JAMA: the Journal of the American Medical Association
Aarti Sudam Salunke, Mahendra Vinayak Nagargoje, Vasudha Abhijit Belgaumkar, Sunil Narayan Tolat, Ravindranath Brahmadev Chavan
INTRODUCTION: Psoriasis is a chronic systemic inflammatory disease where the skin and the joints are the primary targets. Despite the fact that psoriasis carries minimal risk of mortality, it is associated with significant morbidity which may have a significant impact on quality of life of patients. Globally, psoriasis has been reported to be associated with Metabolic Syndrome (MS) including obesity, dyslipidemia, diabetes and hypertension. Association of MS and its various components with psoriasis has been consistently reported in various studies, but there is a paucity of data on this association from the Indian subcontinent...
August 2017: Journal of Clinical and Diagnostic Research: JCDR
James K H Luk, Felix H W Chan
Dementia will become more common as the population ages. Advanced dementia should be considered as a terminal illnesses and end-of-life (EOL) care is very much needed for this disease group. Currently, the EOL services provided to this vulnerable group in Hong Kong, especially those living in residential care homes, is limited. The usual practice of residential care homes is to send older residents with advanced dementia to acute hospitals when they are sick, irrespective of their wish, premorbid status, diagnoses and prognosis...
August 28, 2017: Annals of Palliative Medicine
Paulo Roberto Fagundes da Silva, Maria Cecília de Araújo Carvalho, Maria Tavares Cavalcanti, Rodrigo Cunha Echebarrena, Adriana Santos de Mello, Catarina Magalhães Dahl, Débora Bastos de Lima, Flávia Mitkiewicz de Souza
Critical Time Intervention (CTI) is a time-limited mental health intervention offered to people with mental disorders during critical/transition periods. This study assesses the impact of CTI-BR on social performance and quality of life within a population in the process of deinstitutionalization, after long-term hospitalization in a psychiatric institution. The study population was split into two groups, one of which received CTI plus the regular care. Results showed no advantage of the intervention compared to the regular programs provided by the institution...
July 2017: Ciência & Saúde Coletiva
Vijaya T Daniel, Jason T Wiseman, Julie Flahive, Heena P Santry
BACKGROUND: As the U.S. population ages and the number of emergent surgical repairs for perforated peptic ulcer disease (PUD) rise, contemporary national data evaluating operative outcomes for open surgical repair for perforated PUD among the elderly are lacking. MATERIALS AND METHODS: The National Surgical Quality Improvement Program (2007-2014) was queried for patients ≥65 y who underwent open surgical repair for perforated PUD. The primary outcome was 30-d mortality...
July 2017: Journal of Surgical Research
Yen-Lin Chen, Chun-Hsien Hsu, Chang-Hsun Hsieh, Chung-Ze Wu, Jiunn-Diann Lin, Jin-Biou Chang, Yao-Jen Liang, Yi-Ting Tsai, Te-Lin Hsia, Dee Pei
Hypertension and prehypertension can increase the risk of developing cardiovascular disease (CVD) and diabetes. However, whether the harmful effects of high blood pressure (BP) are also seen with high normotension remains unknown. This 10-year longitudinal follow-up study aimed to investigate the relationships among normal-range BP, metabolic syndrome (MetS), and CVD.A total of 9133 nonmedicated normotensive participants, 4634 males and 4499 females, aged 60 years or older were enrolled in a standard health examination program at 2 academic hospitals and a health screening center in Taiwan...
June 2017: Medicine (Baltimore)
Yan-Yan Wang, Yu-Lin Liao, Lang-Li Gao, Xiu-Ying Hu, Ji-Rong Yue
BACKGROUND: Postoperative delirium is a significant complication in elderly patients. The occurrence of delirium may increase the related physical and psychological risks, delay the length of hospital stays, and even lead to death. According to the current evidence-based model, the application of interdisciplinary intervention may effectively prevent delirium, shorten the length of hospital stays, and save costs. PURPOSE: To establish a culturally appropriate interdisciplinary intervention model for preventing postoperative delirium in older Chinese patients...
June 2017: Hu Li za Zhi the Journal of Nursing
Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien, Chiung-Nien Chen, Ming-Tsan Lin, Guan-Hua Huang, Sharon K Inouye
Importance: Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). Objective: To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. Design, Setting, and Participants: This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012...
September 1, 2017: JAMA Surgery
Simonetta Scalvini, Palmira Bernocchi, Emanuela Zanelli, Laura Comini, Michele Vitacca
Management of chronic diseases in a progressively aging population is a major issue in western industrialized countries and telehealth is one way to ensure the continuity of care in chronic illness. We describe here our personal experience in a telehealth and telecare centre in Italy. Between January 2000 and December 2015, 1635 elderly patients (71% male) with one or more comorbidities have undergone a telehealth program tailored to their specific disease: chronic obstructive pulmonary disease (COPD)/chronic respiratory insufficiency; amyotrophic lateral sclerosis/neuromuscular diseases; chronic heart failure (CHF); post-stroke; and post-cardiac surgery patients discharged from hospital after an acute event...
January 1, 2017: Journal of Telemedicine and Telecare
Noor Heim, Henk F van Stel, Roelof G Ettema, Roos C van der Mast, Sharon K Inouye, Marieke J Schuurmans
BACKGROUND: A pragmatic, stepped wedge trial design can be an appealing design to evaluate complex interventions in real-life settings. However, there are certain pitfalls that need to be considered. This paper reports on the experiences and lessons learned from the conduct of a cluster randomized, stepped wedge trial evaluating the effect of the Hospital Elder Life Program (HELP) in a Dutch hospital setting to prevent older patients from developing delirium. METHODS: We evaluated our trial which was conducted in eight departments in two hospitals in hospitalized patients aged 70 years or older who were at risk for delirium by reflecting on the assumptions that we had and on what we intended to accomplish when we started, as compared to what we actually realized in the different phases of our study...
May 17, 2017: Trials
Tracy Chippendale, Patricia A Gentile, Melissa K James
BACKGROUND/AIM: Health promotion and prevention is an important component of occupational therapy practice. Falls are one of the most common causes of ER visits among older adults and injurious falls requiring trauma care can have a significant impact on the health and quality of life of elders. The aim of this study was to compare characteristics and consequences of falls among older adult trauma patients across different age groups with an eye towards informing injury prevention programs...
October 2017: Australian Occupational Therapy Journal
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