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geriatric home hospitalization

Alice Breining, Antonin Negers, Lucie Mora, Laura Moïsi, Jean L Golmard, Ariel Cohen, Marc Verny, Jean P Collet, Jacques Boddaert
AIM: Myocardial infarction without chest pain misleads the clinician, resulting in a diagnosis delay and an increase of mortality. The main objective of the present study was to determine the risk factors of atypical presentation in older patients with myocardial infarction. METHODS: All consecutive patients aged ≥75 years presenting with myocardial infarction and hospitalized in the cardiology intensive care unit were included in the present prospective multicenter observational study...
October 11, 2018: Geriatrics & Gerontology International
Anne Wissendorff Ekdahl, Anna Axmon, Magnus Sandberg, Katarina Steen Carlsson
INTRODUCTION: Comprehensive geriatric assessment (CGA) is a multidimensional, interdisciplinary diagnostic process used to determine the medical, psychological and functional capabilities of frail older people. The primary aim of our current study is to confirm whether CGA-based outpatient care is superior than usual care in terms of health-related outcomes, resource use and costs. METHODS AND ANALYSIS: The Geriatric Mobile Team trial is designed as a single-centre randomised, controlled, assessor-blinded (at baseline) trial...
October 10, 2018: BMJ Open
Sherrie L Aspinall, Sydney P Springer, Xinhua Zhao, Francesca E Cunningham, Carolyn T Thorpe, Todd P Semla, Ronald I Shorr, Joseph T Hanlon
OBJECTIVES: To examine the association between central nervous system (CNS) medication dosage burden and risk of serious falls, including hip fractures, in individuals with a history of a recent fall. DESIGN: Nested case-control study. SETTING: Veterans Health Administration (VHA) Community Living Centers (CLCs). PARTICIPANTS: CLC residents aged 65 and older with a history of a fall or hip fracture in the year before a CLC admission between July 1, 2005, and June 30, 2009...
October 11, 2018: Journal of the American Geriatrics Society
Elita Santosaputri, Kate Laver, Timothy To
OBJECTIVE: To determine the efficacy of interventions, delivered by geriatrics-trained staff for nursing home residents, in reducing hospitalisation. METHODS: Multiple databases and clinical trial registers were searched. Studies that provided comparative data and involved residents aged ≥65 years evaluating patient-level interventions delivered by geriatrics-trained staff were included. The systematic review protocol was made available on PROSPERO (registration number CRD42017079928; www...
October 7, 2018: Australasian Journal on Ageing
K A Mausbach, J Velten, P Rehmann, G Kolb, B Wöstmann
BACKGROUND: In the future there will be an increasing demand for professional care with simultaneous retention of the dentition in older people. Due to inadequate dental knowledge, it is often not possible for caregivers to adequately assess dental deficits. OBJECTIVE: The aim of the study was to develop and validate a simple tool (Mini Dental Assessment, MDA) to assess possible dental treatment needs (DTN) of residential geriatric facilities by nursing personnel...
October 2, 2018: Zeitschrift Für Gerontologie und Geriatrie
Heidi L Wald, Ravishankar Ramaswamy, Michael H Perskin, Lloyd Roberts, Michael Bogaisky, Winnie Suen, Anna Mikhailovich
Mobility can be defined as the ability to move or be moved freely and easily. In older adults, mobility impairments are common and associated with risk for additional loss of function. Mobility loss is particularly common in these individuals during acute illness and hospitalization, and it is associated with poor outcomes, including loss of muscle mass and strength, long hospital stays, falls, declines in activities of daily living, decline in community mobility and social participation, and nursing home placement...
October 1, 2018: Journal of the American Geriatrics Society
Miquel À Mas, Sebastià J Santaeugènia, Francisco J Tarazona-Santabalbina, Sara Gámez, Marco Inzitari
OBJECTIVES: To compare clinical outcomes in older patients with acute medical crises attended by a geriatrician-led home hospitalization unit (HHU) vs an inpatient intermediate-care geriatric unit (ICGU) in a post-acute care setting. DESIGN: Quasi-experimental longitudinal study, with 30-day follow-up. PARTICIPANTS: Older patients with chronic conditions attended at the emergency department or day hospital for an acute medical crisis. INTERVENTIONS: Patients were referred to geriatrician-led HHU or ICGU wards...
October 2018: Journal of the American Medical Directors Association
Chantal Backman, Anne Harley, Liam Peyton, Craig Kuziemsky, Jay Mercer, Mary Anne Monahan, Sandra Schmidt, Harvinder Singh, Deborah Gravelle
BACKGROUND: As the population ages, the need for appropriate geriatric rehabilitation services will also increase. Pressures faced by hospitals to reduce length of stay and reduce costs have driven the need for more complex care being delivered in the home or community setting. As a result, a multifaceted approach that can provide geriatric rehabilitation patients with safe and effective person- and family-centered care during transitions from hospital to home is required. We hypothesize that a technology-supported person- and family-centered care transition could empower geriatric rehabilitation patients, engage them in shared decision making, and ultimately help them to safely manage their personalized needs during care transitions from hospital to home...
September 24, 2018: JMIR Research Protocols
Mathias Schlögl, Simeon Schietzel, Roland Kunz, Egemen Savaskan, Reto W Kressig, Florian Riese
The Physical Examination of an 'Uncooperative' Elderly Patient Abstract. The physical examination of uncooperative elderly patients regularly presents physicians in the private practice, in the hospital or nursing home with great challenges. The lack of cooperation itself can be an important indication of an underlying medical problem. Important elements to improve the patient's cooperation include ensuring basic needs, sufficient time and patience, adequate communication and good cooperation with relatives and other healthcare professionals...
September 2018: Praxis
Suresh Basnet, Meng Zhang, Martin Lesser, Gisele Wolf-Klein, Guang Qiu, Myia Williams, Renee Pekmezaris, Paola DiMarzio
AIM: We sought to explore the relationship between the number of medications at hospital discharge and 30-day rehospitalization in older adults aged >65 years. METHODS: This was a multicenter cohort study to determine whether an increased number of medications was associated with 30-day rehospitalization in patients aged >65 years. We explored the relationship between rehospitalization and other risk factors. Data were collected from a large health system in the New York metropolitan area from September 2011 to January 2013...
October 2018: Geriatrics & Gerontology International
Ashley W Gerrish, Mark E Hamill, Katie M Love, Daniel I Lollar, Tonja M Locklear, Nitasha Dhiman, Michael S Nussbaum, Bryan R Collier
Geriatric trauma patients with low-level falls often have multiple comorbidities and limited physiologic reserve. Our aim was to investigate postdischarge mortality in this population. We hypothesized that five-year mortality would be higher relative to other blunt mechanisms. The registry of our Level 1 trauma center was queried for patients evaluated between July 2008 and December 2012. Adult patients identified were matched with mortality data from 2008 to 2013 from the National Death Index. Low-level falls were identified by E Codes; other types of blunt trauma were based on registry classification...
August 1, 2018: American Surgeon
Boyoung Jeon, Nanako Tamiya, Satoru Yoshie, Katsuya Iijima, Tatsuro Ishizaki
AIM: The present study aimed to examine the percentage of and risk factors for potentially avoidable hospitalizations (PAH), non-PAH and in-hospital deaths among residents of special nursing homes for the elderly (SNH) and geriatric health service facilities (GHSF). METHODS: Long-term care and national health insurance claims data (April 2012 to September 2013) were obtained from a suburban city in Chiba prefecture, Japan. Study participants were aged ≥75 years and resided in either SNH (n = 1138) or GHSF (n = 885)...
August 2018: Geriatrics & Gerontology International
Carolyn K Clevenger, Janet Cellar, Mariya Kovaleva, Laura Medders, Kenneth Hepburn
The Integrated Memory Care Clinic (IMCC) is a patient-centered medical home as defined by the National Committee for Quality Assurance directed by advanced practice registered nurses (APRNs) caring for persons living with dementia (PLWD); physicians provide specialty consultation but do not direct care or care planning. The IMCC incorporates geriatric nursing, social work, and APRNs from neurology, gerontology, palliative care, and geriatric psychiatry. APRNs provide comprehensive, coordinated primary care for dementia, other chronic conditions, and minor acute illnesses...
August 23, 2018: Journal of the American Geriatrics Society
Juliana M Bernstein, Peter Graven, Kathleen Drago, Konrad Dobbertin, Elizabeth Eckstrom
OBJECTIVES: To design a value-driven, interprofessional inpatient geriatric consultation program coordinated with systems-level changes and studied outcomes and costs. DESIGN: Propensity-matched case-control study of older adults hospitalized at an academic medical center (AMC) who did or did not receive geriatric consultation. SETTING: Single tertiary-care AMC in Portland, Oregon. PARTICIPANTS: Adults aged 70 and older who received an inpatient geriatric consultation (n=464) and propensity-matched controls admitted before development of the consultation program (n=2,381)...
September 2018: Journal of the American Geriatrics Society
Tsuyoshi Okamura, Masaya Shimmei, Akinori Takase, Shiho Toishiba, Kojun Hayashida, Tatsuya Yumiyama, Yukan Ogawa
AIM: The aim of our study was to investigate factors associated with burnout of nurses and care workers in nursing homes and geriatric hospitals in Japan. The use of Buddhist priests, the major religion in Japan, was also explored. METHODS: Questionnaires for nurses and care workers were sent to 10 care facilities. The survey questions included basic demographic information, the Japanese Burnout Index and the Japanese version of the Frommelt Attitude Toward Care Of Dying Scale Form B...
2018: PloS One
Malin Tistad, Maria Flink, Charlotte Ytterberg, Gunilla Eriksson, Susanne Guidetti, Kerstin Tham, Lena von Koch
OBJECTIVE: The objective of the study was to compare the total use of healthcare services in the course of the first year after a stroke between participants who, after the acute care, had received occupational therapy as a client-centred activities of daily living (ADL) intervention (CADL) and participants who had received usual ADL intervention (UADL). DESIGN: A secondary analysis of a multicentre cluster-randomised controlled trial (RCT). SETTING: Primary and secondary care in Sweden...
August 5, 2018: BMJ Open
Monica Berggren, Åsa Karlsson, Nina Lindelöf, Undis Englund, Birgitta Olofsson, Peter Nordström, Yngve Gustafson, Michael Stenvall
OBJECTIVE: This pre-planned secondary analysis of geriatric interdisciplinary home rehabilitation, which was initially found to shorten the postoperative length of stay in hospital for older individuals following hip fracture, investigated whether such rehabilitation reduced the numbers of complications, readmissions, and total days spent in hospital after discharge during a 12-month follow-up period compared with conventional geriatric care and rehabilitation. DESIGN: Randomized controlled trial...
August 1, 2018: Clinical Rehabilitation
Paolo Orlandoni, Nikolina Jukic Peladic, Mirko Di Rosa, Claudia Venturini, Donata Fagnani, Debora Sparvoli, Natascia Giorgini, Redenta Basile, Claudia Cola
BACKGROUND AND AIMS: European and international guidelines advice against initiating tube-feeding in patients with severe dementia. These recommendations are based on studies with important methodological limitations that evaluated the benefits of artificial nutrition in patients with percutaneous endoscopic gastrostomy almost exclusively in terms of the prolongation of survival. The aims of this study were to assess the harmful effects of home enteral nutrition administered via the nasogastric tube and percutaneous endoscopic gastrostomy in patients with advanced dementia in terms of mechanical, gastrointestinal and metabolic complications, to estimate the survival, to explore the risk factors for mortality and to compare the outcomes of patients with advanced dementia with those of patients without dementia...
July 20, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Olivier Beauchet, Shek Fung, Cyrille P Launay, Jonathan Afilalo, Paul Herbert, Marc Afilalo, Julia Chabot
OBJECTIVE: Morbidities and related disabilities often lead to older inpatients having a long hospital stay. The aim of this study was to examine whether the 6-item brief geriatric assessment (BGA), developed and validated in France to determine a priori levels of risk of a long hospital stay (i.e.; low, moderate, high), could be successfully used with patients admitted to a geriatric assessment unit (GAU) in Quebec. STUDY DESIGN: Observational retrospective cohort design...
September 2018: Maturitas
Òscar Miró, Berenice Nayla Brizzi, Sira Aguiló, Xavier Alemany, Javier Jacob, Pere Llorens, Pablo Herrero Puente, Begoña González Ramón, Verónica Castro Jiménez, Victoria Torres Machado, Raquel Cenjor, Adriana Gil, Verònica Rico, Gemma Martínez Nadal, Montserrat Lázaro Del Nogal, Francisco Javier Martín-Sánchez
OBJECTIVES: To profile patients aged 65 years or older who are attended in a hospital emergency department after falls. To describe the falls, their severity, and factors relevant to recommended preventive measures. MATERIAL AND METHODS: The FALL-ER is a multipurpose, multicenter prospective registry of a systematically described cohort of patients aged 65 years or older attended in 5 hospital emergency departments on 52 days of the same year. We collected data on 68 independent variables...
2018: Emergencias: revista de la Sociedad Española de Medicina de Emergencias
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