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https://www.readbyqxmd.com/read/30094830/higher-quality-lower-cost-with-an-innovative-geriatrics-consultation-service
#1
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)...
August 10, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/30092065/a-positive-attitude-towards-provision-of-end-of-life-care-may-protect-against-burnout-burnout-and-religion-in-a-super-aging-society
#2
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
https://www.readbyqxmd.com/read/30082359/resource-use-of-healthcare-services-1-year-after-stroke-a-secondary-analysis-of-a-cluster-randomised-controlled-trial-of-a-client-centred-activities-of-daily-living-intervention
#3
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
https://www.readbyqxmd.com/read/30064264/effects-of-geriatric-interdisciplinary-home-rehabilitation-on-complications-and-readmissions-after-hip-fracture-a-randomized-controlled-trial
#4
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
https://www.readbyqxmd.com/read/30061054/the-outcomes-of-long-term-home-enteral-nutrition-hen-in-older-patients-with-severe-dementia
#5
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
https://www.readbyqxmd.com/read/30049342/predicting-a-long-hospital-stay-after-admission-to-a-geriatric-assessment-unit-results-from-an-observational-retrospective-cohort-study
#6
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
https://www.readbyqxmd.com/read/30033696/profile-of-older-patients-attended-in-the-emergency-department-after-falls-a-fall-er-registry-study-of-the-magnitude-of-the-problem-and-opportunities-for-improving-hospital-emergency-care
#7
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
https://www.readbyqxmd.com/read/30004174/less-than-one-third-of-hip-fracture-patients-return-to-their-prefracture-level-of-instrumental-activities-of-daily-living-in-a-prospective-cohort-study-of-480-patients
#8
Sophie Moerman, Nina Mc Mathijssen, Wim E Tuinebreijer, Rob Ghh Nelissen, Anne Jh Vochteloo
AIM: A significant loss of instrumental activities of daily living (IADL) after a hip fracture has been reported. The aim of the present study was to identify specific predictors for low IADL after a hip fracture, in order to target better postoperative care for these patients. METHODS: A prospective observational cohort study of 480 hip fracture patients was carried out. IADL was measured at baseline, and after 3 and 12 months using the Groningen Activity Restriction Scale...
July 13, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29989278/characteristics-of-older-people-in-an-inpatient-haematology-unit-a-descriptive-study
#9
Janani Thillainadesan, Lisa Ng, Ilona Cunningham, Nicole Wong Doo, Vasi Naganathan
OBJECTIVE: To characterise older inpatients in a haematology unit. METHODS: Hospital case-mix data of haematology separations of all ages (n = 7419) and more extensive data restricted to older patients (age ≥75 years, n = 1025) were evaluated. RESULTS: From 2000 to 2014, there was a 200% increase in those aged ≥85 years who were more likely to have a geriatric syndrome as the principal diagnosis (P < 0.05), have delirium (P < 0.05), receive less intensive treatment (P < 0...
July 10, 2018: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29983361/socioeconomic-and-geographic-disparities-in-accessing-nursing-homes-with-high-star-ratings
#10
Yiyang Yuan, Christopher Louis, Howard Cabral, Jeffrey C Schneider, Colleen M Ryan, Lewis E Kazis
OBJECTIVES: The Centers for Medicare & Medicaid Services Nursing Home Compare (NHC) serves as the most comprehensive repository of Medicaid- and/or Medicare-certified nursing homes providing services to approximately 1.4 million US residents. A gap in the literature exists in understanding on the national level whether residents from socioeconomically disadvantaged counties experience disparities in the access to nursing homes with higher NHC star ratings. The study aimed to examine nursing home quality variations with regard to county-level socioeconomic, geographic, and metropolitan status, while adjusting for nursing home facility-level characteristics...
July 5, 2018: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29976541/identification-of-frailty-by-the-use-of-the-segam-scale-part-a-in-geriatrical-consultation
#11
Abrar-Ahmad Zulfiqar
At present, it is recognized that screening for frailty in the elderly is a major public health issue. Numerous scales have emerged for the purpose of detecting/measuring frailty. METHODS: A prospective, observational study was performed in subjects aged over 75 years, coming from the first neuro-geriatric consultation, from July 3, 2017 to August 18, 2017, included in the CHU Rouen, and benefiting from frailty screening through the use of the grid SEGAm (part A); this correlated with the subjective opinion of the nurse...
July 5, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29957266/reasons-for-home-care-clients-unplanned-hospital-admissions-and-their-associations-with-patient-characteristics
#12
Jukka K Rönneikkö, Esa R Jämsen, Matti Mäkelä, Harriet Finne-Soveri, Jaakko N Valvanne
BACKGROUND: Unplanned hospitalizations and emergency room visits occur frequently among home care clients The aim of this study was to identify typical discharge diagnoses and their associations with patient characteristics among a total of 6812 Finnish home care clients aged ≥63 years who were hospitalized within one year of their first home care assessment. METHODS: A register-based study based on Resident Assessment Instrument-Home Care (RAI-HC) assessments and nationwide hospital discharge records...
June 22, 2018: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29954403/the-cardiac-care-bridge-program-design-of-a-randomized-trial-of-nurse-coordinated-transitional-care-in-older-hospitalized-cardiac-patients-at-high-risk-of-readmission-and-mortality
#13
L Verweij, P Jepma, B M Buurman, C H M Latour, R H H Engelbert, G Ter Riet, F Karapinar-Çarkit, S Daliri, R J G Peters, W J M Scholte Op Reimer
BACKGROUND: After hospitalization for cardiac disease, older patients are at high risk of readmission and death. Although geriatric conditions increase this risk, treatment of older cardiac patients is limited to the management of cardiac diseases. The aim of this study is to investigate if unplanned hospital readmission and mortality can be reduced by the Cardiac Care Bridge transitional care program (CCB program) that integrates case management, disease management and home-based cardiac rehabilitation...
June 28, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29951221/gerimedrisk-a-telemedicine-geriatric-pharmacology-consultation-service-to-address-adverse-drug-events-in-long-term-care-a-stepped-wedge-cluster-randomized-feasibility-trial-protocol-isrctn17219647
#14
Joanne Man-Wai Ho, Jennifer Tung, Janine Maitland, Derelie Mangin, Lehana Thabane, J Michael Pavlin, Jeffrey Alfonsi, Anne Holbrook, Sharon Straus, Sophiya Benjamin
Background: Multimorbidity, polypharmacy, and older age predispose seniors to adverse drug events (ADE). Seniors with an ADE experience greater morbidity, mortality, and health care utilization compared to their younger counterparts. To mitigate and manage ADEs among this vulnerable population, we designed a geriatric pharmacology consultation service connecting clinicians with specialist physicians and pharmacists and will investigate the feasibility and acceptability of this complex intervention in the long-term care setting, prior to conducting a larger efficacy trial...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/29941408/rehospitalization-following-a-stay-in-geriatric-rehabilitation-wards-rates-and-predictive-factors
#15
Marie Tardivel, Florence Muller, Danièle Tortrat, Laurent Lechowski, Laurent Teillet
Hospitalization in the elderly patients is highly associated with morbi-mortality. Geriatric post-acute and rehabilitation care wards are designed to provide care and to implement life project of elderly patients. Objective of this study was to characterize rehospitalizations after a stay in geriatric post-acute and rehabilitation care wards. METHODS: The study was retrospective, case-control, including all the patients hospitalized in the 4 geriatric post-acute and rehabilitation care wards of a hospital in Paris (France) and returned at home...
June 22, 2018: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/29936664/preoperative-nutritional-status-is-associated-with-progression-of-postoperative-cardiac-rehabilitation-in-patients-undergoing-cardiovascular-surgery
#16
Yasuhiro Arai, Toru Kimura, Yuki Takahashi, Takashi Hashimoto, Mamoru Arakawa, Homare Okamura
OBJECTIVE: Progression of cardiac rehabilitation after cardiovascular surgery can be affected by frailty. The nutritional status of the patient has been proposed as an indicator of frailty. In this study, we aimed to evaluate the influence of preoperative nutritional status on the progress of postoperative cardiac rehabilitation. METHODS: This study included 146 patients (82 males, 64 females, average age 71.9 ± 12.0 years) who underwent elective cardiovascular surgery...
June 23, 2018: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29929867/-hip-fracture-in-the-elderly-patient-prognostic-factors-for-mortality-and-functional-recovery-at-one-year
#17
Mariano de Miguel Artal, Olga Roca Chacón, Montse Martínez-Alonso, Marcos Serrano Godoy, Jaume Mas Atance, Roberto García Gutiérrez
OBJECTIVE: The aim of this study is to identify the risks factors for mortality and functional recovery in elderly patients admitted to hospital with a hip fracture. MATERIALS AND METHODS: Longitudinal prospective study in patients 80 years old or more and patients between 75 and 79 in residential home care with a hip fracture and with a past medical history of dementia or followed-up by the Geriatric Unit. A total of 359 patients were included, and the demographic data, previous functional status, comorbidity, type of fracture, and dementia were recorded...
June 18, 2018: Revista Española de Geriatría y Gerontología
https://www.readbyqxmd.com/read/29922079/the-cost-of-dysphagia-in-geriatric-patients
#18
Signe Westmark, Dorte Melgaard, Line O Rethmeier, Lars Holger Ehlers
Objectives: To estimate the annual cost at the hospital and in the municipality (social care) due to dysphagia in geriatric patients. Design: Retrospective cost analysis of geriatric patients with dysphagia versus geriatric patients without dysphagia 1 year before hospitalization. Setting: North Denmark Regional Hospital, Hjørring Municipality, Frederikshavn Municipality, and Brønderslev Municipality. Subjects: A total of 258 hospitalized patients, 60 years or older, acute hospitalized in the geriatric department...
2018: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/29914394/mortality-and-associated-risk-factors-for-older-adults-admitted-to-the-emergency-department-a-hospital-cohort
#19
Carmen García-Peña, Mario Ulises Pérez-Zepeda, Leslie Viridiana Robles-Jiménez, Sergio Sánchez-García, Ricardo Ramírez-Aldana, Pamela Tella-Vega
BACKGROUND: Older emergency department patients are more vulnerable than younger patients, yet many risk factors that contribute to the mortality of older patients remain unclear and under investigation. This study endeavored to determine mortality and factors associated with mortality in patients over 60 years of age who were admitted to the emergency departments of two general hospitals in Mexico City. METHODS: This is a hospital cohort study involving adults over 60 years of age admitted to the emergency department and who are beneficiaries of the Mexican Institute of Social Security and residents of Mexico City...
June 18, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29909664/predicting-in-hospital-mortality-in-older-general-surgical-patients
#20
A Vilches-Moraga, J Fox, A Paracha, A Gomez-Quintanilla, J Epstein, L Pearce
Introduction A significant number of emergency general surgical admissions occur in older patients. Clinical decision making in this group is challenging and current risk prediction tools extrapolate data from cohorts of younger patients. This is the first UK study to examine risk factors predicting in-hospital mortality in older acute surgical patients undergoing comprehensive geriatric assessment. Methods This was a prospective study of consecutive patients aged ≥75 years admitted non-electively to general surgery wards between September 2014 and February 2017 who were reviewed by an elderly medicine in-reach service...
June 18, 2018: Annals of the Royal College of Surgeons of England
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