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https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#1
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28633384/correlates-of-dyspnoea-and-its-association-with-adverse-outcomes-in-a-cohort-of-adults-aged-80-and-over
#2
Eralda Hegendörfer, Bert Vaes, Catharina Matheï, Gijs Van Pottelbergh, Jean-Marie Degryse
Background: adults aged 80 and over, a fast growing age-group, with increased co-morbidity and frailty have not been the focus of previous research on dyspnoea. We investigate the correlates of dyspnoea and its association with adverse outcomes in a cohort of adults aged 80 and over. Methods: about 565 community-dwelling adults aged 80 and over of the BELFRAIL prospective cohort had assessment of Medical Research Council dyspnoea scale (MRC), forced expiratory volume in 1 s (FEV1), N-terminal pro-brain natriuretic peptide (NT-proBNP), physical performance tests, grip strength, 15 items geriatric depression scale, activities of daily living (ADL), body mass index (BMI) and demographics data...
June 14, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28632933/patient-characteristics-associated-with-a-successful-response-to-nurse-led-care-programs-targeting-the-oldest-old-a-comparison-of-two-rcts
#3
Nienke Bleijenberg, Lorenz Imhof, Romy Mahrer-Imhof, Margaret I Wallhagen, Niek J de Wit, Marieke J Schuurmans
BACKGROUND: To improve the effectiveness of community-based care programs, especially those targeting the oldest-old population (80+), data are needed that elucidate those factors associated with a successful response to the intervention. Two comparable nurse-led care programs have been evaluated in two large randomized controlled trials (RCTs), one in Switzerland and one in the Netherlands. AIMS: To identify common patient characteristics that are related to a successful response to proactive nurse-led care, we explored if and to what extent, identical factors were present in both study populations...
June 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28632340/prescribing-in-the-oldest-old-inpatients-a-retrospective-analysis-of-patients-referred-for-specialist-geriatric-consultation
#4
Sivarajah Ilango, Peter Pillans, Nancye M Peel, Ian Scott, Leonard C Gray, Ruth E Hubbard
INTRODUCTION: While medications may prolong life and prevent morbidity in older people, adverse effects of polypharmacy are increasingly recognised. As patients age and become frail, prescribing may be expected to focus more on symptom control and minimise potentially harmful preventive medication use that confer little benefit within a short lifespan. Whether prescribing practice shifts to one of symptom control among the oldest old admitted to hospital remains unclear. METHODS: Retrospective analysis of all patients aged ≥85 years referred for comprehensive geriatric assessment at a tertiary care hospital between May 2006 and December 2014 for whom all prescribed medications were documented...
June 20, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28631455/the-prognostic-importance-of-chronic-end-stage-diseases-in-geriatric-patients-admitted-to-163-italian-icus
#5
Daniele Poole, Stefano Finazzi, Giovanni Nattino, Danilo Radrizzani, Giuseppe Gristina, Paolo Malacarne, Sergio Livigni, Guido Bertolini
BACKGROUND: The number of elderly patients undergoing major surgical interventions and then needing admission to intensive care unit (ICU) grows steadily. We investigated this issue in a cohort of 232,278 patients admitted in 5 years (2011-2015) to 163 Italian general ICUs. METHODS: Surgical patients older than 75 registered in the GiViTI MargheritaPROSAFE project were analysed. The impact on hospital mortality of important chronic conditions (severe COPD, NYHA class IV, dementia, end-stage renal disease, cirrhosis with portal hypertension) was investigated with two prognostic models developed yearly on patients staying in the ICU less or more than 24 hours...
June 14, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28631275/a-typology-of-interprofessional-teamwork-in-acute-geriatric-care-a-study-in-55-units-in-belgium
#6
Ruth D Piers, Karen J J Versluys, Johan Devoghel, Sophie Lambrecht, André Vyt, Nele J Van Den Noortgate
OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. DESIGN: Cross-sectional multicenter study. SETTING: Acute geriatric units in Belgium. PARTICIPANTS: Team members of different professional backgrounds. MEASUREMENTS: Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents...
June 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28627042/deciding-about-nursing-home-care-in-dementia-a-conjoint-analysis-of-how-older-people-balance-competing-goals
#7
Alison Fahey, Dearbhail Ní Chaoimh, Grainne R Mulkerrin, Eamon C Mulkerrin, Shaun T O'Keeffe
AIM: "Don't put me in a home" is a common preference of older people, but so too is "I don't want to be a burden on my family." These and other goals often conflict with each other when people have worsening dementia and the issue of possible nursing home admission arises. METHODS: Community-dwelling older hospital patients were asked to imagine that they lived alone, had dementia and were experiencing increasing practical difficulties, and were presented with 11 possible "outcome packages...
June 18, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28625940/prodromal-stage-of-disease-dementia-with-lewy-bodies-how-to-diagnose-in-practice
#8
Frédéric Blanc, Marc Verny
Disease with Lewy bodies or dementia with Lewy bodies (DLB), particularly at the prodromal stage, is a complex disease to diagnose because of different clinical beginnings and variable paths in terms of clinical expression. Thus DLB can be entcountered in different input modes: mild cognitive impairment, depression, acute behavioral disorders, confusion and delirium, or sleep disorders. In the aim to better diagnose the disease, should be sought obviously to search for the key symptoms: fluctuations, hallucinations, extra-pyramidal syndrome, and REM sleep behavior disorder...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28625935/evaluation-of-prescription-along-three-health-care-periods-in-the-elderly
#9
Fannie Santoni, Valéry Antoine, Alberto di Castri, Maurice Viala, Laetitia Geronimi-Robelin, Cédric LeGuillou, Christine de Taddeo, Sophie Bastide, Claude Jeandel, Benoit de Wazieres
Polypharmacy, potentially inappropriate prescriptions and inadequate coordination between prescribers are among main factors explaining the occurrence of adverse drug events in elderly patients. Prospective and descriptive study of medication prescriptions for elderly patients during a continuous period of health-care: entry in an acute geriatric unit (T1), at discharge (T2) and two months after hospitalization (T3). A global iatrogenic risk was defined: presence of poly-pharmacy and/or PPI (Laroche criteria) and/or absence of quality indicators for prescription according to the French health authority...
June 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28623800/inpatient-geriatric-care-in-sweden-important-factors-from-an-inter-disciplinary-team-perspective
#10
Anna Cristina Åberg, Anna Ehrenberg
The purpose of this study was to describe factors of importance for the quality of inpatient geriatric care from an inter-disciplinary team perspective, an area that has not been previously studied to our knowledge. The study design was qualitative descriptive with data being collected from focus-group interviews with members of geriatric care teams. The data collection was conducted at a Swedish university hospital with 69 beds for geriatric care. It comprised five group interviews with a total of 32 staff members, including representatives of all the seven professions working with geriatric care...
June 10, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28621029/urinary-tract-infection-in-patients-with-hip-fracture-an-underestimated-event
#11
Christopher Bliemel, Benjamin Buecking, Juliana Hack, Rene Aigner, Daphne-Asimenia Eschbach, Steffen Ruchholtz, Ludwig Oberkircher
AIM: Urinary tract infections (UTI) represent a common perioperative complication among elderly patients with hip fracture. To determine the impact of UTI on the perioperative course of elderly patients with hip fractures, a prospective study was carried out. METHODS: A total of 402 surgically-treated geriatric hip fracture patients were consecutively enrolled at a level 1 trauma center. On admission, all patients received an indwelling urinary catheter. Clinically symptomatic patients were screened more closely for UTI...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28620978/comparison-of-healthcare-utilization-and-life-sustaining-interventions-between-elderly-patients-with-dementia-and-those-with-cancer-near-the-end-of-life-a-nationwide-population-based-study-in-taiwan
#12
Yu-Han Chen, Chung-Han Ho, Chien-Cheng Huang, Ya-Wen Hsu, Yueh-Chun Chen, Ping-Jen Chen, Guan-Ting Chen, Jhi-Joung Wang
AIM: Little is known about the pattern of healthcare services for end-of-life patients with dementia (PwD) in East Asia. We compared this pattern between PwD and cancer patients in their last year of life in Taiwan. METHODS: Taiwan's National Health Insurance Research Database was applied for this case-control analysis. The records of patients who had dementia and died between 2002 and 2011 were reviewed. The control group was decedents with cancer. The utilization of hospitalization, emergency department visits and life-sustaining interventions during the last year of life between the two groups were compared...
June 16, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28619861/geriatrics-and-the-legal-system
#13
Stephanie C Yarnell, Paul D Kirwin, Howard V Zonana
Correctional systems, already struggling to meet the basic and functional requirements of older prisoners, will be further challenged by the increasing medical and psychiatric needs of this population. Mental health and general medical care for older adults requires specific on-site or consultation expertise in geriatric medicine and psychiatry, as well as potential changes in infrastructure, both of which may be prohibitively expensive. However, compassionate and effective treatment of older prisoners requires that prison and legal systems facilitate this expert care...
June 2017: Journal of the American Academy of Psychiatry and the Law
https://www.readbyqxmd.com/read/28617622/treatment-and-communication-that-is-what-matters-an-analysis-of-complaints-regarding-end-of-life-care
#14
Jiska Cohen-Mansfield, Michal Skornick-Bouchbinder, Rinat Cohen, Shai Brill
BACKGROUND: Investigating complaints concerning end-of-life (EoL) care is a necessary step for improving the quality of life at its final stage. OBJECTIVE: We aimed to classify and quantify the aspects of EoL care that require improvement by analyzing caregivers' feedback on the care their relatives received before death. DESIGN: A survey of primary family caregivers of deceased patients. SETTING/SUBJECTS: Relatives of decedents were recruited through two geriatric medical centers and from persons contacted for other studies, who reported losing a relative...
June 15, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28614541/knowledge-and-attitudes-towards-dementia-among-final-year-medical-students-in-brazil
#15
Alessandro Ferrari Jacinto, Vanessa de Albuquerque Citero, José Luiz de Lima, Paulo José Fortes Villas Boas, Adriana Polachini do Valle, Ananda Ghelfi Raza Leite
Objective: Among all countries, Brazil is expected to have the sixth largest elderly population in 2025. Dementia syndromes are prominent among aging-related diseases. Despite the necessity of and curriculum for training in geriatric medicine to make recommendations on an approach to this theme, adequate training appears to be infrequent. The present study aimed to evaluate the knowledge about dementia and students' attitude towards it during the last semester of the medical course in two of the most important Brazilian medical schools...
April 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28614041/effect-of-short-term-research-training-programs-on-medical-students-attitudes-toward-aging
#16
Dilip V Jeste, Julie Avanzino, Colin A Depp, Maja Gawronska, Xin Tu, Daniel D Sewell, Steven F Huege
Strategies to build a larger workforce of physicians dedicated to research on aging are needed. One method to address this shortage of physician scientists in geriatrics is short-term training in aging research for early-stage medical students. The authors examined the effects of two summer research training programs, funded by the National Institutes of Health, on medical students' attitudes toward aging, using the Carolina Opinions on Care of Older Adults (COCOA). The programs combined mentored research, didactics, and some clinical exposure...
June 14, 2017: Gerontology & Geriatrics Education
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#17
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#18
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28602461/adapting-systems-of-care-for-people-aging-with-hiv
#19
Eugenia L Siegler, Mark Brennan-Ing
People aging with HIV have medical and psychosocial needs that require more than the HIV services network can provide. HIV providers may lack experience managing multimorbidity or the functional consequences of aging. Social support services may be unable to provide necessary services for people living with HIV (PLWH) who are becoming increasingly frail or facing cognitive impairment. HIV providers will be caring for aging PLWH whose HIV management may seem simple compared with the significant burdens of stigma, mental health needs, social isolation, multimorbidity, and aging-related syndromes...
May 26, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28602414/the-older-adult-with-locoregionally-advanced-head-and-neck-squamous-cell-carcinoma-knowledge-gaps-and-future-direction-in-assessment-and-treatment
#20
Ronald Maggiore, Zachary S Zumsteg, Karlynn BrintzenhofeSzoc, Kelly M Trevino, Ajeet Gajra, Beatriz Korc-Grodzicki, Joel B Epstein, Stewart M Bond, Ira Parker, Julie A Kish, Barbara A Murphy, Noam A VanderWalde
Older adults with head and neck squamous cell carcinoma (HNSCC) pose unique treatment and supportive care challenges to oncologists and other cancer care providers. The majority of patients with HNSCC present with locoregionally advanced disease, for which combined-modality treatment integrating chemotherapy and radiation therapy is often necessary to maximize tumor control. However, applying these approaches to an older population with concomitant comorbidities and a higher risk of functional impairments remains challenging and is exacerbated by the paucity of studies involving older adults...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
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