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Older persons assessment and liaison

Richard H Lee, Megan Pearson, Kenneth W Lyles, Patricia W Jenkins, Cathleen Colon-Emeric
INTRODUCTON: Low-trauma, osteoporotic fractures among older men are associated with a significant increase in morbidity and mortality. Despite effective therapies for osteoporosis, several studies have demonstrated that management and treatment after a low trauma fracture remains inadequate, especially among men. Fracture liaison services have been shown to significantly improve osteoporosis evaluation and treatment. However, such programs may be less feasible and accessible in rural areas, with limited availability of specialty services...
January 2016: Rural and Remote Health
Andrea Singer, Alex Exuzides, Leslie Spangler, Cynthia O'Malley, Chris Colby, Karissa Johnston, Irene Agodoa, Jessica Baker, Risa Kagan
OBJECTIVES: To provide a national estimate of the incidence of hospitalizations due to osteoporotic fractures (OFs) in women; compare this with the incidence of myocardial infarction (MI), stroke, and breast cancer; and assess temporal trends in the incidence and length of hospitalizations. PATIENTS AND METHODS: The study included all women 55 years and older at the time of admission, admitted to a hospital participating in the US Nationwide Inpatient Sample for an outcome of interest...
January 2015: Mayo Clinic Proceedings
Inderpal Singh, Sharan Ramakrishna, Kathryn Williamson
The rising prevalence of dementia will have an effect on acute care hospitals around the world. At present, around 40% of patients older than 70 years with acute medical admissions have dementia, but only half of these patients have been diagnosed. Patients with dementia have poorer health outcomes, longer hospital stays, and higher rates of readmissions and institutionalization. Worldwide, health care budgets are severely constrained. National Institute for Health and Care Excellence (NICE) has listed ten quality standards for supporting people in living well with dementia...
2013: Clinical Interventions in Aging
Victor A Molinari, Lisa M Brown, Kathryn A Frahm, John A Schinka, Roger Casey
PURPOSE: To understand the needs and challenges encountered by older homeless veterans. METHODS: We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers. RESULTS: Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs...
May 2013: Journal of Health Care for the Poor and Underserved
Isabelle De Brauwer, Sylvain Lepage, Jean-Cyr Yombi, Pascale Cornette, Benoît Boland
BACKGROUND AND AIMS: Hip fracture in older persons is a frequent reason for hospital admission and a substantial workload in orthopedic wards for geriatric liaison teams. However, robust patients who do not present in-hospital complications may not need geriatric liaison. For the sake of triage, we studied the ability of usual admission scores to identify patients who will not develop in-hospital complications, and who may therefore not be included in the overworked geriatric liaison teams...
February 2012: Aging Clinical and Experimental Research
Surendra K Mattoo, Sandeep Grover, Kaustav Chakravarty, Paula T Trzepacz, David J Meagher, Nitin Gupta
Delirium is understudied in developing countries, where there tends to be a lower proportion of older persons and comorbid dementia. The authors assessed 100 consecutive cases of DSM-IV delirium (patients' mean age: 44.4 [standard deviation: 19.4] years; mean DRS-R98 score: 25.6 [3.6]) referred to an adult Consultation-Liaison Psychiatry service in Northern India. Disturbances of attention, orientation, visuospatial ability, and sleep disturbance were the most frequent symptoms, followed by language, thought-process abnormality, and motor agitation...
2012: Journal of Neuropsychiatry and Clinical Neurosciences
Sue Tucker, Jane Hughes, Caroline Sutcliffe, David Challis
AIM: To explore the implications of providing intensive care management in a typical old age mental health service in North West England. METHODS: The time spent by core groups of specialist mental health and social services staff on a range of activities deemed central to the provision of intensive care management was explored by means of a diary exercise. The difference between what is actually being done and what evidence suggests is needed was examined. RESULTS: More than 1500 hours of activity were appraised...
May 2008: Australian Health Review: a Publication of the Australian Hospital Association
D Harari, F C Martin, A Buttery, S O'Neill, A Hopper
BACKGROUND: Reducing hospital length of stay (LOS) in older acute medical inpatients is a key productivity measure. Evidence-based predictors of greater LOS may be targeted through Comprehensive Geriatric Assessment (CGA). OBJECTIVE: Evaluate a novel service model for CGA screening of older acute medical inpatients linked to geriatric intervention. SETTING: Urban teaching hospital. SUBJECTS: Acute medical inpatients aged 70+ years...
November 2007: Age and Ageing
Jane McCusker, Josée Verdon
BACKGROUND: Hospital emergency departments (EDs) serve an aging population with an increased burden on health resources. Few studies have examined the effects of comprehensive geriatric assessment interventions on ED use. This study aimed to systematically review the literature and compare the effects of these interventions on ED visits. METHODS: Relevant articles were identified through electronic databases and a search of reference lists and personal files. Inclusion criteria included: original research (written in English or French) on interventions conducted in noninstitutionalized populations 60 years old or older, not restricted to a particular medical condition, in which ED visits were a study outcome...
January 2006: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Mary E Dunnion, Billy Kelly
AIM: The purpose of this study was to explore dimensions of the management of the older person following care in an emergency department in preparation for discharge home by identifying perceptions and attitudes of staff in both emergency department and primary care sectors. BACKGROUND: It is recognized that older people discharged home directly from the emergency department are a vulnerable group. Effective communication and liaison are seen to be keys to the provision of high quality care for older people in the emergency department and in ensuring a seamless care between sectors...
July 2005: Journal of Clinical Nursing
Stephen Abbott, Julienne Meyer, Jeannette Copperman, Jane Bentley, Anne Lanceley
BACKGROUND: Every NHS trust and Primary Care Trust (PCT) in England now has a Patient Advice and Liaison Service (PALS) which provides an identifiable person to whom service users can turn if they have a problem or need information while using the NHS. This paper reports data from a 2-year qualitative study of London PALS. OBJECTIVE: To develop patient-centred criteria by which to assess PALS. DESIGN: Data were generated from qualitative interviews with 15 PALS service users and 15 members of local user/carer organizations, and from a workshop with representatives of 14 user/carer organizations (national and London-wide)...
June 2005: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
Annette E Maxwell, Roshan Bastani, Perlaminda Vida, Umme S Warda
Recruitment and retention of subjects in cancer prevention, screening, and treatment trials is challenging, especially if subjects are low-income, from minority groups or immigrants with limited English fluency. This article describes our experiences in recruiting 530 female Filipino-American immigrants at community based organizations and churches for a randomized trial that assessed the effect of a small group educational session on breast and cervical cancer screening. We found that a personal invitation from either a female project liaison, a friend, or the Filipino project director were all successful strategies that resulted in over 80% attendance at an educational session that was offered as part of the study...
June 2005: Journal of Community Health
Robert Baldwin, Helen Pratt, Hannah Goring, Alison Marriott, Chris Roberts
OBJECTIVE: To determine the clinical effectiveness of a nurse-led mental health liaison service in managing mental health problems in older physically ill inpatients. DESIGN: Randomised controlled trial. SETTING: Four general medical wards in a district general hospital in a northern UK town. PARTICIPANTS: 153 medically ill older people (aged 65 or over) who scored above the threshold for depression and/or cognitive impairment on a brief screening instrument (4-item geriatric depression scale and 6-item orientation-memory-concentration test): 77 were randomised to a nurse-led intervention and 76 to usual care...
September 2004: Age and Ageing
D K Miller, L M Lewis, M J Nork, J E Morley
OBJECTIVE: To evaluate the effects of a program of case-finding and liaison service for older patients visiting the emergency department. DESIGN: Nonrandomized controlled trial with systematically assembled intervention cohort and matched control group. SETTING: An urban teaching hospital. PARTICIPANTS: There were 385 intervention subjects aged 65 years and older and 385 control subjects matched by day of visit, gender, and age within 5 years...
May 1996: Journal of the American Geriatrics Society
D M Clarke, D P McKenzie, G C Smith
The recognition of depression was examined in 987 medical and surgical patients referred to a consultation-liaison psychiatry service. Overall concordance of recognition of depression by the referring doctor and diagnosis of depression by the consultant psychiatrist was 74%; 41% false-positive rate, 15% false-negative rate. Concordance was higher in the Renal Unit and lower in the General Medical Unit. Patients for whom there was discordance were significantly older than those for whom there was concordance...
April 1995: Journal of Psychosomatic Research
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