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Geriatric care

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https://www.readbyqxmd.com/read/28340250/improving-safety-culture-in-hospitals-facilitators-and-barriers-to-implementation-of-systemic-falls-investigative-method-sfim
#1
Aleksandra A Zecevic, Alvin Ho-Ting Li, Charity Ngo, Michelle Halligan, Anita Kothari
Objective: The purpose of this study was to assess the facilitators and barriers to implementation of the Systemic Falls Investigative Method (SFIM) on selected hospital units. Design: A cross-sectional explanatory mixed methods design was used to converge results from a standardized safety culture survey with themes that emerged from interviews and focus groups. Findings were organized by six elements of the Ottawa Model of Research Use framework. Setting: A geriatric rehabilitation unit of an acute care hospital and a neurological unit of a rehabilitation hospital were selected purposefully due to the high frequency of falls...
March 17, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28338866/the-growing-challenge-of-major-trauma-in-older-people-a-role-for-comprehensive-geriatric-assessment
#2
James Michael Fisher, Charlotte Bates, Jay Banerjee
In this commentary article, we describe the impact that an ageing population is having on the nature of major trauma seen in emergency departments. The proportion of major trauma victims who are older people is rapidly increasing and a fall from standing is now the most common mechanism of injury in major trauma. Potential barriers to effective care of this patient group are highlighted, including: a lack of consensus regarding triage criteria; potentially misleading physiological parameters within triage criteria; non-linear patient presentations and diagnostic nihilism...
March 10, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28335759/mobile-radiography-services-in-nursing-homes-a-systematic-review-of-residents-and-societal-outcomes
#3
Elin Kjelle, Kristin Bakke Lysdahl
BACKGROUND: Demographic changes are leading to an ageing population in Europe, and predict an increase in the number of nursing home residents over the next 30 years. Nursing home residents need specialised healthcare services such as radiology due to both chronic and acute illnesses. Mobile radiography, x-ray examinations performed in the nursing homes, may be a good way of providing services to this population. The aim of this systematic review was to identify the outcomes of mobile radiography services for nursing home residents and society...
March 23, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#4
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28333613/collaborative-management-of-neurocognitive-disorders-in-primary-care-explorations-of-an-attempt-at-culture-change
#5
Lewis Mehl-Madrona, Barbara Mainguy
INTRODUCTION: Minor neurocognitive disorder (MiND; previously mild cognitive impairment) is a transitional zone between normal cognitive function and early stages of major neurocognitive disorder (previously called dementia). Of people with MiND, 5% to 10% progress to major neurocognitive disorder. Simple interventions such as memory activities, balance exercises, and anti-inflammatory diets have been shown to improve cognitive ability. Also, education and support in group settings have proved beneficial for patients with MiND...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#6
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28330419/how-does-sex-affect-the-care-dependency-risk-one-year-after-stroke-a-study-based-on-claims-data-from-a-german-health-insurance-fund
#7
Susanne Schnitzer, Johannes Deutschbein, Christian H Nolte, Martin Kohler, Adelheid Kuhlmey, Liane Schenk
OBJECTIVES: The study explores the association between sex and care dependency risk one year after stroke. METHODS: The study uses claims data from a German statutory health insurance fund. Patients were included if they received a diagnosis of ischemic or hemorrhagic stroke between 1 January and 31 December 2007 and if they survived for one year after stroke and were not dependent on care before the event (n = 1851). Data were collected over a one-year period...
March 22, 2017: Topics in Stroke Rehabilitation
https://www.readbyqxmd.com/read/28329340/baseline-characteristics-of-participants-in-the-aspree-aspirin-in-reducing-events-in-the-elderly-study
#8
John J McNeil, Robyn L Woods, Mark R Nelson, Anne M Murray, Christopher M Reid, Brenda Kirpach, Elsdon Storey, Raj C Shah, Rory S Wolfe, Andrew M Tonkin, Anne B Newman, Jeff D Williamson, Jessica E Lockery, Karen L Margolis, Michael E Ernst, Walter P Abhayaratna, Nigel Stocks, Sharyn M Fitzgerald, Ruth E Trevaks, Suzanne G Orchard, Lawrence J Beilin, Geoffrey A Donnan, Peter Gibbs, Colin I Johnston, Richard H Grimm
Background: There are no primary prevention trials of aspirin with relevant geriatric outcomes in elderly people. ASPirin in Reducing Events in the Elderly (ASPREE) is a placebo-controlled trial of low-dose aspirin that will determine whether 5 years of daily 100-mg enteric-coated aspirin extends disability-free and dementia-free life in a healthy elderly population and whether these benefits outweigh the risks. Methods: Set in primary care, this randomized double-blind placebo-controlled trial has a composite primary endpoint of death, incident dementia or persistent physical disability...
January 20, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28327565/impaired-nutritional-status-in-geriatric-trauma-patients
#9
F S Müller, O W Meyer, P Chocano-Bedoya, S Schietzel, M L Gagesch, G Freystaetter, V Neuhaus, H-P Simmen, W Langhans, H A Bischoff-Ferrari
BACKGROUND/OBJECTIVES: Malnutrition is an established risk factor for adverse clinical outcomes. Our aim was to assess nutritional status among geriatric trauma patients. SUBJECTS/METHODS: We enrolled 169 consecutive patients (⩾70 years) admitted to the Geriatric Traumatology Centre (University Hospital Zurich, Switzerland). On admission to acute care, nutritional status was assessed with the mini nutritional assessment (score<17=malnourished (M), ⩽23.5=at risk of malnutrition (ARM), >23...
March 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28325586/-prognostic-indices-for-older-adults-during-the-year-following-hospitalization-in-an-acute-medical-ward-an-update
#10
Josephine Thomazeau, Samantha Huo Yung Kai, Yves Rolland, Sandrine Sourdet, Nicolas Saffon, Fati Nourhashemi
CONTEXT: As population grow older, chronic diseases are more prevalent. It leads to an increase of hospitalization for acute decompensation, sometimes iterative. Management of these patients is not always clear, and care provided is not always proportional to life expectancy. Making decisions in acute situations is not easy. OBJECTIVE: This review aims to list and describe mortality scores within a year following hospitalization of patients of 65 years or older...
March 18, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28323335/surgical-guidelines-for-perioperative-management-of-older-adults-what-geriatricians-need-to-know
#11
Jessica L Colburn, Sanjay Mohanty, John R Burton
A multidisciplinary panel of experts representing surgery, anesthesia, and geriatrics recently published guidelines for surgeons on the optimal perioperative management of older adults, including recommendations on postoperative recovery and posthospital transitions of care. Geriatricians have an important role in the care for older adults in the preoperative period as older adults consider surgical options and prepare for surgical procedures, during the perioperative period as inpatient consultants, and in the postoperative period as older adults transition to rehabilitation facilities or to home...
March 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28322487/methodology-for-senior-proof-guidelines-a-practice-example-from-the-netherlands
#12
Barbara C van Munster, Johanna E A Portielje, Andrea B Maier, Arend J Arends, Johannes J A de Beer
RATIONALE, AIMS AND OBJECTIVES: Evidence-based guidelines constitute a foundation for medical decision making. It is often unclear whether recommendations in general guidelines also apply to older people. This study aimed to develop a methodology to increase the focus on older people in the development of guidelines. METHODS: The methodology distinguishes 4 groups of older people: (1) relatively healthy older people; (2) older people with 1 additional specific (interfering) comorbid condition; (3) older people with multimorbidity; and (4) vulnerable older people...
March 21, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28320331/a-multi-component-cognitive-behavioural-intervention-for-the-treatment-of-fear-of-falling-after-hip-fracture-fit-hip-protocol-of-a-randomised-controlled-trial
#13
Maaike N Scheffers-Barnhoorn, Jolanda C M van Haastregt, Jos M G A Schols, Gertrudis I J M Kempen, Romke van Balen, Jan H M Visschedijk, Wilbert B van den Hout, Eve M Dumas, Wilco P Achterberg, Monica van Eijk
BACKGROUND: Hip fracture is a common injury in the geriatric population. Despite surgical repair and subsequent rehabilitation programmes, functional recovery is often limited, particularly in individuals with multi-morbidity. This leads to high care dependency and subsequent use of healthcare services. Fear of falling has a negative influence on recovery after hip fracture, due to avoidance of activity and subsequent restriction in mobility. Although fear of falling is highly prevalent after hip fracture, no structured treatment programme is currently available...
March 20, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28319319/association-between-religious-practice-and-risk-of-depression-in-older-people-in-the-subacute-setting
#14
Alice Lac, Nicole Austin, Renata Lemke, Suma Poojary, Peter Hunter
OBJECTIVE: To identify the association between religious practice and risk of depression in older people admitted to a subacute hospital. METHODS: A cross-sectional survey was conducted with 100 patients aged ≥65 years with Mini-Mental State Examination (MMSE) scores ≥24 consecutively admitted to a subacute hospital. Religious practice was measured using the Duke University Religion Index and risk of depression using the 15-item Geriatric Depression Scale (GDS)...
March 20, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28315047/putting-dementia-awareness-into-general-practice-the-cadif-approach
#15
Michael Pentzek, Horst Christian Vollmar, Stefan Wilm, Verena Leve
BACKGROUND: International studies show that dementia is often recognized at later stages in general practice. Pure knowledge-sharing interventions could not change this in a sustainable manner. Concepts for changing attitudes of general practitioners (GPs) are required. OBJECTIVES: What barriers affect GPs' recognition of and diagnostic approach to dementia? What recommendations for a GP-specific diagnostic procedure can be derived from this? METHODS: Metasynthesis of qualitative studies with GPs on barriers to dementia recognition, explication of the "frailty" concept and the diagnostic approach described therein and the development of an approach in cases of suspected cognitive decline in a multiprofessional team...
March 17, 2017: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/28314550/sense-of-life-worth-living-ikigai-and-incident-functional-disability-in-elderly-japanese-the-tsurugaya-project
#16
Kentaro Mori, Yu Kaiho, Yasutake Tomata, Mamoru Narita, Fumiya Tanji, Kemmyo Sugiyama, Yumi Sugawara, Ichiro Tsuji
OBJECTIVE: To test the hypothesis that elderly persons who feel ikigai (a sense of life worth living) have a lower risk of incident functional disability than those who do not. Recent studies have suggested that ikigai impacts on mortality. However, its impact upon disability is unknown. The aim of the present study was to investigate the association between ikigai and incident functional disability among elderly persons. METHODS: We conducted a prospective cohort study of 830 Japanese elderly persons aged ≥70years as a comprehensive geriatric assessment in 2003...
April 2017: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/28306149/medicare-access-and-chip-reauthorization-act-what-do-geriatrics-healthcare-professionals-need-to-know-about-the-quality-payment-program
#17
Kathleen T Unroe, Peter A Hollmann, Alanna C Goldstein, Michael L Malone
Commencing in 2017, the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 will change how Medicare pays health professionals. By enacting MACRA, Congress brought an end to the (un)sustainable growth rate formula while also setting forth a vision for how to transform the U.S. healthcare system so that clinicians deliver higher-quality care with smarter spending by the Centers for Medicare and Medicaid Services (CMS). In October 2016, CMS released the first of what stakeholders anticipate will be a number of (annual) rules related to implementation of MACRA...
March 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28303060/evaluation-of-the-association-between-locomotive-syndrome-and-depressive-states-a-cross-sectional-study
#18
Tomohiro Saito, Hideaki Watanabe, Ichiro Kikkawa, Katsushi Takeshita
The Japanese Orthopaedic Association has proposed the term "locomotive syndrome" to designate a condition that places a person at high risk for long-term care. However, in daily clinical practice, even when a diagnosis of locomotive syndrome is made, exercise therapy often cannot be successfully performed in some patients owing to their lack of motivation. We speculated that locomotive syndrome and depressive states co-exist in elderly people. The purpose of this study was to determine the presence or absence of depressive states in older patients aged ≥ 65 years who were diagnosed with locomotive syndrome...
February 2017: Nagoya Journal of Medical Science
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#19
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28302309/best-practices-for-chiropractic-care-for-older-adults-a-systematic-review-and-consensus-update
#20
Cheryl Hawk, Michael J Schneider, Mitchell Haas, Paul Katz, Paul Dougherty, Brian Gleberzon, Lisa Z Killinger, John Weeks
OBJECTIVE: The purpose of this study was to update evidence-based recommendations on the best practices for chiropractic care of older adults. METHODS: The project consisted of a systematic literature review and a consensus process. The following were searched from October 2009 through January 2016: MEDLINE, Index to Chiropractic Literature, CINAHL (Cumulative Index to Nursing and Allied Health Literature), AMED (Allied and Complementary Medicine Database), Alt HealthWatch, Cochrane Database of Systematic Reviews, and Cochrane Registry of Controlled Trials...
March 14, 2017: Journal of Manipulative and Physiological Therapeutics
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