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Hospital elder life program

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https://www.readbyqxmd.com/read/28866906/end-of-life-care-for-advanced-dementia-patients-in-residential-care-home-a-hong-kong-perspective
#1
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
https://www.readbyqxmd.com/read/28724016/deinstitutionalization-of-long-stay-patients-in-a-psychiatric-hospital-in-rio-de-janeiro
#2
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
https://www.readbyqxmd.com/read/28688634/predictors-of-mortality-in-the-elderly-after-open-repair-for-perforated-peptic-ulcer-disease
#3
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
https://www.readbyqxmd.com/read/28640118/high-normotension-is-associated-with-future-metabolic-syndrome-but-not-cardiovascular-disease-a-10-year-longitudinal-study
#4
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)
https://www.readbyqxmd.com/read/28580557/-localization-establishment-of-an-interdisciplinary-intervention-model-to-prevent-post-operative-delirium-in-older-patients-based-on-hospital-elder-life-program
#5
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
https://www.readbyqxmd.com/read/28538964/effect-of-a-modified-hospital-elder-life-program-on-delirium-and-length-of-hospital-stay-in-patients-undergoing-abdominal-surgery-a-cluster-randomized-clinical-trial
#6
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
https://www.readbyqxmd.com/read/28537509/maugeri-centre-for-telehealth-and-telecare-a-real-life-integrated-experience-in-chronic-patients
#7
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
https://www.readbyqxmd.com/read/28514964/help-problems-in-executing-a-pragmatic-randomized-stepped-wedge-trial-on-the-hospital-elder-life-program-to-prevent-delirium-in-older-patients
#8
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
https://www.readbyqxmd.com/read/28508437/characteristics-and-consequences-of-falls-among-older-adult-trauma-patients-considerations-for-injury-prevention-programs
#9
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...
May 15, 2017: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/28451835/significance-of-sequential-cardiac-rehabilitation-program-through-inter-hospital-cooperation-between-acute-care-and-rehabilitation-hospitals-in-elderly-patients-after-cardiac-surgery-in-japan
#10
Tomoyuki Morisawa, Katsuhiro Ueno, Yuko Fukuda, Naoto Kanazawa, Hiroshi Kawaguchi, Rikito Zaiki, Hiroaki Fuzisaki, Haruka Yoshioka, Maki Sasaki, Kentaro Iwata, Tadaaki Koyama, Takeshi Kitai, Yutaka Furukawa, Tetsuya Takahashi
This study is to evaluate the impact of cooperation between acute care hospital and rehabilitation hospital on physical function, exercise tolerance, activities of daily living (ADL), health-related quality of life (HR-QOL), and psychological function in heart disease patients undergoing cardiac rehabilitation. Among patients undergoing concurrent medical treatment and cardiac rehabilitation starting early in acute care hospitalization, we selected 30 patients who required continued cardiac rehabilitation in rehabilitation hospitals as subjects...
April 27, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28347337/the-effect-of-intervening-hospitalizations-on-the-benefit-of-structured-physical-activity-in-promoting-independent-mobility-among-community-living-older-persons-secondary-analysis-of-a-randomized-controlled-trial
#11
RANDOMIZED CONTROLLED TRIAL
Thomas M Gill, Daniel P Beavers, Jack M Guralnik, Marco Pahor, Roger A Fielding, Michelle Hauser, Todd M Manini, Anthony P Marsh, Mary M McDermott, Anne B Newman, Heather G Allore, Michael E Miller
BACKGROUND: Among older persons, disability is often precipitated by intervening illnesses and injuries leading to hospitalization. In the Lifestyle Interventions and Independence for Elders (LIFE) Study, a structured moderate-intensity physical activity program, compared with a health education program, was shown to significantly reduce the amount of time spent with major mobility disability (MMD) over the course of 3.5 years. We aimed to determine whether the benefit of the physical activity program in promoting independent mobility was diminished in the setting of intervening hospitalizations...
March 28, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28223851/a-phenomenological-study-on-resilience-of-the-elderly-suffering-from-chronic-disease-a-qualitative-study
#12
Parkhide Hassani, Fatemeh-Sadat Izadi-Avanji, Mahnaz Rakhshan, Hamid Alavi Majd
BACKGROUND: Resilience is a key factor in improving health and attenuating problems caused by chronic diseases in the elderly. Having a clear understanding of its meaning in a specific population can be of great help in taking efficient steps toward better health services. Given the lack of information in this regard, the aim of this study was to understand the meaning of resilience for hospitalized older people who experience chronic conditions. METHODS: The study was carried out as a qualitative work based on a descriptive phenomenological approach...
2017: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/28167723/longer-periods-of-hospice-service-associated-with-lower-end-of-life-spending-in-regions-with-high-expenditures
#13
Shiyi Wang, Sylvia H Hsu, Siwan Huang, Pamela R Soulos, Cary P Gross
Hospice use is expected to decrease end-of-life expenditures, yet evidence for its financial impact remains inconclusive. One potential explanation is that the use of hospice may produce differential cost-savings effects by region because of geographic variation in end-of-life spending patterns. We examined 103,745 elderly Medicare fee-for-service beneficiaries in the Surveillance, Epidemiology, and End Results Program Medicare database who died from cancer in 2004-11. We created quintiles by the adjusted mean end-of-life expenditures per hospital referral region (HRR), and we examined HRR-level variation in the association between length of hospice service and expenditures across quintiles...
February 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28144397/pancreatic-resection-in-very-elderly-patients-a-critical-analysis-of-existing-evidence
#14
REVIEW
Cosimo Sperti, Lucia Moletta, Gioia Pozza
The aging of the population results in a rise of number of elderly patients (aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34...
January 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28120023/-help-hospital-elder-life-program-multimodal-delirium-prevention-in-elderly-patients
#15
REVIEW
K Singler, C Thomas
Delirium in older adults is associated with an increased risk for cognitive and functional decline. Multiple risk factors, such as underlying dementia, multiple comorbidities, anticholinergic medication or visual and hearing impairment foster the incidence of delirium. By identification of patients at risk and the initiation of a multiple component delirium prevention program delirium is preventable in 30-40% of all cases. There is broad evidence for comprehensive multicomponent delirium prevention strategies in patient care, but their implementation is still lacking in many hospitals...
February 2017: Der Internist
https://www.readbyqxmd.com/read/28068906/cherish-collaboration-for-hospitalised-elders-reducing-the-impact-of-stays-in-hospital-protocol-for-a-multi-site-improvement-program-to-reduce-geriatric-syndromes-in-older-inpatients
#16
RANDOMIZED CONTROLLED TRIAL
Alison M Mudge, Merrilyn D Banks, Adrian G Barnett, Irene Blackberry, Nicholas Graves, Theresa Green, Gillian Harvey, Ruth E Hubbard, Sharon K Inouye, Sue Kurrle, Kwang Lim, Prue McRae, Nancye M Peel, Jessica Suna, Adrienne M Young
BACKGROUND: Older inpatients are at risk of hospital-associated geriatric syndromes including delirium, functional decline, incontinence, falls and pressure injuries. These contribute to longer hospital stays, loss of independence, and death. Effective interventions to reduce geriatric syndromes remain poorly implemented due to their complexity, and require an organised approach to change care practices and systems. Eat Walk Engage is a complex multi-component intervention with structured implementation, which has shown reduced geriatric syndromes and length of stay in pilot studies at one hospital...
January 9, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28057111/-health-economic-evaluation-of-a-23-value-pneumococcal-polysaccharide-vaccination-pilot-programme-among-elderly-chronic-obstructive-pulmonary-disease-patients-in-china
#17
Y P Qiu, K Zhao, X Li, L W Shi, W D Guo, X R Qi, B Y Sui, R M Zhou
Objective: From the perspective of health economics, to evaluate 23 pneumococcal polysaccharide vaccination programme among chronic obstructive pulmonary disease (COPD) patient. Methods: In the pilot counties of the project of integrated care pathway for COPD patient (Hanbin district of Hanzhong city in Shanxi Province, Qianjian district of Qingqing city, Huandao district of Qindao city in Shangdong Province, Wen county of Jiaozuo city in Henan Province), information of insurance participants of New Rural Cooperative Medical System (NRCS) was collected by local NRCM information system, which included general information as well as records of medical care and medical fee...
December 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/27924187/evaluating-outcomes-in-patients-with-overactive-bladder-within-an-integrated-healthcare-delivery-system-using-a-treatment-patterns-analyzer
#18
Daniel B Ng, Melissa McCart, Christopher Klein, Chelsey Campbell, Robert Schoenhaus, Todd Berner
BACKGROUND: Overactive bladder (OAB) is a relatively common disease that has been linked to a variety of comorbidities, reductions in quality of life, and increased healthcare costs. Antimuscarinic agents are the standard of care among pharmacologic treatments for OAB, but these drugs are linked to high levels of anticholinergic burden, especially in the elderly. OBJECTIVE: To demonstrate how efficient data analysis can be used to identify gaps in care as a result of improvement strategies for OAB within an integrated healthcare delivery system setting...
September 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27923343/feasibility-and-cost-effectiveness-of-a-multidisciplinary-home-telehealth-intervention-programme-to-reduce-falls-among-elderly-discharged-from-hospital-study-protocol-for-a-randomized-controlled-trial
#19
RANDOMIZED CONTROLLED TRIAL
Alessandro Giordano, Gian Pietro Bonometti, Fabio Vanoglio, Mara Paneroni, Palmira Bernocchi, Laura Comini, Amerigo Giordano
BACKGROUND: Fall incidents are the third cause of chronic disablement in elderly according to the World Health Organization (WHO). Recent meta-analyses shows that a multifactorial falls risk assessment and management programmes are effective in all older population studied. However, the application of these programmes may not be the same in all National health care setting and, consequently, needs to be evaluated by cost-effectiveness studies before to plan this intervention in regular care...
December 7, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27922514/factors-associated-with-intestinal-constipation-in-chronic-patients-with-stroke-sequelae-undergoing-rehabilitation
#20
Tânia Mara Nascimento de Miranda Engler, Márcia Helena de Assis Aguiar, Íris Aline Brito Furtado, Samile Pereira Ribeiro, Pérola de Oliveira, Paulo Andrade Mello, Marcele Pescuma Capeletti Padula, Paulo Sérgio Siebra Beraldo
The objective of this study was to define which stroke-related factors constitute independent variables in the incidence of intestinal constipation (IC) of chronic patients admitted to a hospital rehabilitation program. All patients consecutively admitted for rehabilitation were recruited for the study. In the Poisson multiple regression analysis using a hierarchical model, sociodemographic variables, comorbidities, medication, previous history of constipation, life habits, and stroke-related variables were considered for defining factors associated with IC...
November 2016: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
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