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Geriatric care

Yibo Li, Jenelle L Pederson, Thomas A Churchill, Adrian S Wagg, Jayna M Holroyd-Leduc, Kannayiram Alagiakrishnan, Raj S Padwal, Rachel G Khadaroo
BACKGROUND: Frailty is a state of vulnerability to diverse stressors. We assessed the impact of frailty on outcomes after discharge in older surgical patients. METHODS: We prospectively followed patients 65 years of age or older who underwent emergency abdominal surgery at either of 2 tertiary care centres and who needed assistance with fewer than 3 activities of daily living. Preadmission frailty was defined according to the Canadian Study of Health and Aging Clinical Frailty Scale as "well" (score 1 or 2), "vulnerable" (score 3 or 4) or "frail" (score 5 or 6)...
February 20, 2018: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Ladislav Kabelka
Geriatric palliative care must be based on quality geriatric medicine. This applies in particular the multidisciplinary care of patients with geriatric frailty syndrome, most often associated with the polymorbidity of chronic diseases. The model of early indication of the needs of fragile geriatric patients is not more widely available in the current Czech health and social system. Therefore, the necessary early indication of specialized palliative care is not available in hospital facilities. Regional models of conceptual solutions are a necessary next step in development...
2018: Casopís Lékar̆ů C̆eských
Yen-Chun Lin, Lian-Hua Huang
Self-supporting care is an emerging concept in the geriatric care system of Taiwan. The traditional care model tends to prioritize aspects such as "safety" and "convenient and effective". For older adult patients, this situation has led to excessive restrictions, enforced bedrest, and the use of adult diapers, which seriously deteriorate quality of life. The present article introduces the development and current status of self-supporting care and international empirical research results from the perspective of holistic care for older adults as well as describes the intervention strategies that are currently used in Taiwan...
April 2018: Hu Li za Zhi the Journal of Nursing
Ngoc Huong Lien Ha, Mei Sian Chong, Robin Wai Munn Choo, Wai Jia Tam, Philip Lin Kiat Yap
BACKGROUND: Although foreign domestic workers (FDWs) play a significant role in caring for frail seniors in Singapore and are vulnerable to caregiving burden, there has been little research conducted hitherto. We explored caregiver burden and its determinants in this study. METHODS: FDWs (N = 221, M age = 32.3, SD = 6.23) recruited from a hospital geriatric unit completed the Zarit Burden Interview (ZBI) administered in English, Bahasa Melayu, or Burmese. Univariate and multivariate regression were employed to investigate factors influencing caregiving burden in FDWs...
March 21, 2018: International Psychogeriatrics
Martin Klietz, Amelie Tulke, Lars H Müschen, Lejla Paracka, Christoph Schrader, Dirk W Dressler, Florian Wegner
Background: Parkinson's disease (PD) is the second most frequent neurodegenerative disease of the elderly. Patients suffer from various motor and non-motor symptoms leading to reduced health-related quality of life (HRQOL) and an increased mortality. Their loss of autonomy due to dementia, psychosis, depression, motor impairments, falls, and swallowing deficits defines a phase when palliative care interventions might help to sustain or even improve quality of life. Objective: The aim of this study was to investigate the current status of palliative care implementation and quality of life in a local cohort of advanced PD patients in order to frame and improve future care...
2018: Frontiers in Neurology
Eric J Charles, Nicholas J Napoli, Lily E Johnston, Carrie A Foster, Deirdre A Goode, Trevor B Parker, Eleanor A Sharp, Laura Barnes, Jeffrey S Young
The most common mechanism of traumatic injury is ground-level fall. The objective of this study was to understand how patients sustaining falls and their outcomes have evolved. An institutional trauma database was used to identify adult patients who suffered a fall and were admitted to a Level I trauma center during two distinct time periods: 1998 to 2003 (past) and 2008 to 2013 (current). Data on anticoagulant use and comorbidities was gathered by retrospective chart review of patients treated during 2003 and 2013...
March 1, 2018: American Surgeon
Dolores Sánchez-Rodríguez, Cédric Annweiler, Natalia Ronquillo-Moreno, Andrea Tortosa-Rodríguez, Anna Guillén-Solà, Olga Vázquez-Ibar, Ferran Escalada, Josep M Muniesa, Ester Marco
BACKGROUND: Malnutrition is a prevalent condition related to adverse outcomes in older people. Our aim was to compare the diagnostic capacity of the malnutrition criteria of the European Society of Parenteral and Enteral Nutrition (ESPEN) with other classical diagnostic tools. METHODS: Cohort study of 102 consecutive in-patients ≥70 years admitted for postacute rehabilitation. Patients were considered malnourished if their Mini-Nutritional Assessment-Short Form (MNA-SF) score was ≤11 and serum albumin <3 mg/dL or MNA-SF ≤ 11, serum albumin <3 mg/dL, and usual clinical signs and symptoms of malnutrition...
March 16, 2018: Archives of Gerontology and Geriatrics
Hui-Wan Chuang, Chi-Wen Kao, Ming-Der Lee, Yue-Cune Chang
Depression is a common issue in institutionalized elderly people. The "Attentively Embracing Story" theory is applied to help individuals transform negative thoughts into positive, and reflect on spiritual healing. This study aimed to examine the effectiveness of a "Story-Centred Care Intervention Program" based on the "Attentively Embracing Story" theory in improving depressive symptoms, cognitive function, and heart rate variability in institutionalized elderly people. Seventy long-term care residents were recruited from two long-term care facilities and randomized into the story-centred care intervention (n = 35) and control groups (n = 35)...
2018: PloS One
Linda Aimée Hartford Kvæl, Jonas Debesay, Anne Langaas, Asta Bye, Astrid Bergland
OBJECTIVE: Although the concept of patient participation has been discussed for a number of years, there is still no clear definition of what constitutes the multidimensional concept, and the application of the concept in an intermediate care (IC) context lacks clarity. Therefore this paper seeks to identify and explore the attributes of the concept, to elaborate ways of understanding the concept of patient participation for geriatric patients in the context of IC. METHODS: Walker and Avant's model of Concept analysis [1] based on a literature review...
March 5, 2018: Patient Education and Counseling
M Gioffrè-Florio, L M Murabito, C Visalli, F P Pergolizzi, F Famà
AIM: Trauma, in geriatric patients, increases with age, and is a leading cause of disability and institutionalization, resulting in morbidity and mortality. The aim of our study was to analyse the prevalence of trauma, the related risk factors, mortality and sex differences in the prevalence in a geriatric population. PATIENTS AND METHOD: We observed 4,554 patients (≥65 years) with home injuries or car accidents. Patients were evaluated with ISS (Injury Severity Score) and major trauma with ATLS (Advanced Trauma Life Support)...
January 2018: Il Giornale di Chirurgia
Franziska A Herbst, Maria Heckel, Johanna M Tiedtke, Thomas Adelhardt, Alexander Sturm, Stephanie Stiel, Christoph Ostgathe
BACKGROUND: There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education...
March 16, 2018: Zeitschrift Für Gerontologie und Geriatrie
Jesús Abelardo Barea-Mendoza, Mario Chico-Fernández, Marcelino Sánchez-Casado, Ismael Molina-Díaz, Manuel Quintana-Díaz, José Manuel Jiménez-Moragas, Jon Pérez-Bárcena, Juan Antonio Llompart-Pou
INTRODUCTION: We compared the Geriatric Trauma Outcome Score (GTOS) with the probability of survival using the TRISS methodology (PS-TRISS) in geriatric severe trauma patients admitted to Intensive Care Units (ICU) participating in the Spanish trauma ICU registry (RETRAUCI). METHODS: Retrospective analysis from the RETRAUCI. Quantitative data were reported as median (Interquartile Range (IQR)), and categorical data as number (percentage). We analyzed the validity of the GTOS and PS-TRISS to predict survival...
March 13, 2018: Cirugía Española
Rahman Barry, Errington Thompson
INTRODUCTION: Rib fractures after blunt trauma contribute substantially to morbidity and mortality in the elderly. METHODS: Retrospective review of 255 patients ≥65 years old at a level 2 trauma center over 6 years, who sustained blunt trauma resulting in rib fractures. Outcomes measured include mortality, hospital length of stay(LOS), intensive care unit(ICU) admission, ICU LOS, need for MV, and MV days. RESULTS: There were 24 deaths (9...
March 9, 2018: American Journal of Surgery
Brittany Ellis, Christopher R Carpenter, Judy A Lowthian, Simon P Mooijaart, Christian H Nickel, Don Melady
No abstract text is available yet for this article.
March 16, 2018: CJEM
Alberto Pilotto, Raffaella Boi, Jean Petermans
Recently, the interest of industry, government agencies and healthcare professionals in technology for aging people has increased. The challenge is whether technology may play a role in enhancing independence and quality of life and in reducing individual and societal costs of caring. Information and communication technologies, i.e. tools aimed at communicating and informing, assistive technologies designed to maintain older peoples' independence and increasing safety, and human-computer interaction technologies for supporting older people with motility and cognitive impairments as humanoid robots, exoskeletons, rehabilitation robots, service robots and companion-type are interdisciplinary topics both in research and in clinical practice...
March 13, 2018: Age and Ageing
Mohammed Saji Salahudeen, Prasad S Nishtala
OBJECTIVE: To summarize studies that used the international Resident Assessment home care instrument (interRAI HC) to examine study outcomes for older people. METHODS: A comprehensive systematic search was performed to identify relevant studies, using five databases from 1990 until October 2016. The Cochrane Risk-Bias assessment tool and Newcastle-Ottawa Scale was used to assess the quality of RCTs and non-RCTs, respectively. RESULTS: Based on the full-text analysis, 40 studies met the inclusion criteria out of 506 total records...
March 2, 2018: Clinical Gerontologist
Eleonore V Grant, Adam H Skolnick, Joshua Chodosh, Michael H Perskin, Nicole M Orr, Caroline Blaum, John A Dodson
More than 13 million persons in the United States aged 65 and older have cardiovascular disease (CVD), and this population is expected to increase exponentially over the next several decades. In the absence of clinical studies that would inform how best to manage this population, there is an urgent need for collaborative, thoughtful approaches to their care. Although cardiologists are traditionally regarded as leaders in the care of older adults with CVD, these individuals have multiple comorbidities, physiological differences, and distinct goals of care than younger patients that require a specialized geriatric lens...
March 15, 2018: Journal of the American Geriatrics Society
W Weinrebe, S Käbe-Frisch, I Füsgen, M Karaman, E Johannsdottir, S Rupp
OBJECTIVE: To compare the efficacy of desmopressin and placebo in independent geriatric outpatients with nocturnal polyuria (NP). METHODS: A prospective, randomized, single-center, national, double blind, placebo-controlled, fixed-dose, parallel group comparative trial was carried out. The study included 110 geriatric outpatients, 55 patients per treatment group using desmopressin acetate nasal spray (strength: 0.1 mg/ml) once daily of 10 μg/spray blast or placebo...
March 14, 2018: Zeitschrift Für Gerontologie und Geriatrie
Markus Kneihsl, Christian Enzinger, Kurt Niederkorn, Gerit Wünsch, Lisa Müller, Valeriu Culea, Andreas Lueger, Franz Fazekas, Thomas Gattringer
BACKGROUND: Stroke has become a treatable condition with increasing evidence of treatment benefits in older people. However, stroke mimics in geriatric patients are especially prevalent, causing incorrect suspicion and consecutive burden to patients and emergency room resources. We therefore examined the dimension of this problem by investigating emergency room admissions from nursing homes for suspected stroke. METHODS: We performed a retrospective cohort study of all nursing home residents who were admitted to the neurological emergency room of our primary and tertiary care university hospital between 2013 and 2015...
March 14, 2018: Cerebrovascular Diseases
Tyler Sheetz, Cheryl T Lee
PURPOSE OF REVIEW: As the population ages, urologic oncologists are caring for older and more vulnerable patients that must withstand complex surgical treatments. Our healthcare environment emphasizes surgical quality, reductions in length of hospital stay, reduced readmission rates, and high patient satisfaction. So those who manage urologic malignancies must be able to optimize their patients. Understanding the concept of frailty, how to diagnose it in a timely and reliable manner, appreciate its perioperative impact, and consider interventions to reduce its effects may improve surgical outcomes...
March 13, 2018: Current Opinion in Urology
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