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geriatric home hospitalization

Ai Shiraishi, Yoshihiro Yoshimura, Hidetaka Wakabayashi, Yuri Tsuji, Makio Yamaga, Hiroaki Koga
AIM: To examine the effects of oral management provided by dental hygienists (DH) on patient outcomes in post-acute rehabilitation. METHODS: We carried out a retrospective cohort study with 1056 patients newly admitted to a post-rehabilitation hospital in Japan. DH care was defined as two or more consecutive instances of oral management provided by a ward DH during hospitalization. The primary outcome was the motor domain of Functional Independence Measure score at discharge...
December 5, 2018: Geriatrics & Gerontology International
Marianne Wallis, Elizabeth Marsden, Andrea Taylor, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Colleen Johnston, Amanda Glenwright, Julia Crilly
BACKGROUND: To evaluate a Geriatric Emergency Department Intervention (GEDI) model of service delivery for adults aged 70 years and older. METHODS: A pragmatic trial of the GEDI model using a pre-post design. GEDI is a nurse-led, physician-championed, Emergency Department (ED) intervention; developed to improve the care of frail older adults in the ED. The nurses had gerontology experience and education and provided targeted geriatric assessment and streamlining of care...
December 3, 2018: BMC Geriatrics
Yacine Jaïdi, Adrien Guilloteau, Vignon Nonnonhou, Laurie-Anne Bertholon, Sarah Badr, Isabella Morrone, Jean-Luc Novella, Rachid Mahmoudi
BACKGROUND: A high anticholinergic burden (AB) is associated with the occurrence of behavioral and psychological symptoms (BPSDs), which are frequent in dementia. OBJECTIVES: Our aim was to determine the threshold for a reduction in AB that would lead to a clinically significant improvement in BPSDs (in terms of frequency, severity, and disruptiveness). DESIGN: A single-center prospective study. SETTINGS: Dedicated geriatric care unit specializing in the management of patients with dementia...
November 28, 2018: Journal of the American Medical Directors Association
Rahman G Barry, Thao T Wolbert, Farid B Mozaffari, Peter D Ray, Errington C Thompson, Todd W Gress, David A Denning
BACKGROUND: Blunt trauma in the geriatric population is fraught with poor outcomes, with injury severity and comorbidities impacting morbidity and mortality. METHODS: We retrospectively reviewed 2172 patients aged ≥65 y who fell, requiring hospital admission between January 2012 and December 2016. There were 403 patients in the surgical arm (SA) and 1769 patients in the medical arm (MA). Ground-level falls were the only mechanism of injury included. We excluded all ICU admissions and deaths within 24 h...
January 2019: Journal of Surgical Research
Ivonne Hernandez Schulman, Wayne Balkan, Joshua M Hare
Chronic diseases and degenerative conditions are strongly linked with the geriatric syndrome of frailty and account for a disproportionate percentage of the health care budget. Frailty increases the risk of falls, hospitalization, institutionalization, disability, and death. By definition, frailty syndrome is characterized by declines in lean body mass, strength, endurance, balance, gait speed, activity and energy levels, and organ physiologic reserve. Collectively, these changes lead to the loss of homeostasis and capability to withstand stressors and resulting vulnerabilities...
2018: Frontiers in Nutrition
Carolien E M Benraad, Luc Disselhorst, Nicky C W Laurenssen, Peter H Hilderink, René J F Melis, Jan Spijker, Marcel G M Olde Rikkert
OBJECTIVES: Frailty, multimorbidity and functional decline predict adverse health outcomes in community dwelling older people and older patients in general hospitals. This study investigates whether these characteristics separately are independent predictors of health outcomes of acute psychiatric hospitalization. METHODS: Observational study in a prospectively sampled cohort of older patients, consecutively admitted to a psychiatric hospital. On admission we assessed frailty (Frailty Index and walking speed); multimorbidity (Cumulative Index Rating Scale Geriatrics (CIRS-G)) and functional status (Barthel Index)...
November 18, 2018: Aging & Mental Health
Maike Wolters, Dorothee Volkert, Melanie Streicher, Eva Kiesswetter, Gabriel Torbahn, Eibhlís M O'Connor, Mary O'Keeffe, Mary Kelly, Eileen O'Herlihy, Paul W O'Toole, Suzanne Timmons, Emma O'Shea, Patricia Kearney, Judith van Zwienen-Pot, Marjolein Visser, Isabelle Maitre, Virginie Van Wymelbeke, Claire Sulmont-Rossé, Gabriele Nagel, Marion Flechtner-Mors, Sabine Goisser, Ruth Teh, Antje Hebestreit
BACKGROUND & AIMS: Malnutrition is widespread among older people and related to poor outcome. Reported prevalences vary widely, also because of different diagnostic criteria used. This study aimed to describe prevalences in several populations of older persons in different settings using harmonized definitions. METHODS: Available studies within the Joint Programming Initiative (JPI) Knowledge Hub 'Malnutrition in the Elderly' (MaNuEL) were used to calculate and compare prevalences of malnutrition indicators: low BMI (<20 kg/m2 ; age-specific BMI <20 if age 65-<70 and <22 kg/m2 if age ≥70 years), previous weight loss (WL), moderate and severe decrease in food intake, and combined BMI <20 kg/m2 and/or WL in participants aged ≥65 years...
November 3, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
Mark Bloch
The life expectancy of people living with HIV (PLHIV) has dramatically improved with effective and well-tolerated antiretroviral therapy. This presents a new challenge in caring for this patient population, with up to 28% of older PLHIV being identified as frail. Studies suggest that the prevalence of frailty is higher in PLHIV compared to the general population, and that the onset of frailty occurs at an earlier age. Frail individuals often present with multiple and non-specific health complaints, fluctuating disability, falls and delirium, and are at higher risk for multiple adverse outcomes, post-operative complications, poor responses to vaccination and functional decline...
November 16, 2018: AIDS Research and Therapy
M Kiselinova, A Velghe, R Piers, B Verhasselt, N Van Den Noortgate
Pneumonia is one of the leading causes of death in older people, with high mortality rates (> 80%). One of the bacterial pathogens causing pneumonia is Staphylococcus aureus. The unique adaptive ability of S. aureus to a broad range of antibiotics has led to the emergence of methicillin-resistant S. aureus (MRSA) strain. MRSA pneumonia remains a relatively uncommon infection in older people, but it is associated with a very high mortality rate. We report two cases of MRSA pneumonia that highlight the severe clinical presentation and virulence of MRSA infections in geriatric population...
November 16, 2018: Acta Clinica Belgica
Gerardo Fasce Pineda, José M Aravena Castro, Carolina Araya Orellana, Ruby Bustamante Muñoz, Francisco Gonzalez Andrade, Constanza Briceño Ribot, Tiare Quiroz Opazo, Esperanza Araya Orellana, Gonzalo Navarrete Hernandez
BACKGROUND AND OBJECTIVE: Re-admission to hospital by the elderly is a frequent event that is associated with complications. The aim of this article is to describe a randomised clinical trial protocol which has the aim of describing and comparing the impact of a home-based intervention by Occupational Therapists (OT) in the likelihood of re-admission at 6 months. MATERIAL AND METHOD: Randomised controlled trial conducted in medical units of the "Hospital Clínico de la Universidad de Chile" and "Hospital de la Fuerza Aérea de Chile", with 217 patients aged 60 years or older admitted for acute or decompensated chronic disease, provided that they have a person of reference after hospital discharge...
November 2018: Revista Española de Geriatría y Gerontología
Elsa Bourcier, Amandine Baptiste, Adrien Borowik, Lucas Zerbib, Dominique Bonnet-Zamponi, Florence Tubach, Christine Fernandez, Patrick Hindlet
BACKGROUND: Sedative-hypnotics (SHs) are widely used in France but there are no available data addressing their prescription specifically in hospitalized older patients. The objective is thus to determine the cumulative incidence of sedative-hypnotic (SH) medications initialized during a hospital stay of older patients, the proportion of SH renewal at discharge among these patients and to study associated risk factors. METHODS: We conducted a retrospective observational study in six internal medicine units and six acute geriatric units in eight hospitals (France)...
November 14, 2018: BMC Geriatrics
Sevgi Seyhan
Background and Aims: Decubitus ulcer (DU) is one of the commonly observed health problems among home care patients. As well as deteriorating social, physical, and psychological conditions of the patients, it is a cause of severe economic loss due to long-term bed occupancy and high care costs. This study aimed to examine the factors which affect the development of decubitus ulcer among home care patients and provide extensive data to the literature. Patients and Methods: This study was conducted with on home care patients aged over 40 years old who were registered at Etimesgut Ankara Sehit Sait Erturk State Hospital...
October 2018: Indian Journal of Palliative Care
Subraham Pany, Lipilekha Patnaik, E Venkata Rao, Sumitra Pattanaik, Trilochan Sahu
Context: The care of sick members is the hallmark of a civilized society. End-of-life care and social security for elderly are emerging issues nowadays. Aims: The aim of this study is to explore the desires of the elderly regarding the end-of-life care decisions along with to find out social security measures among the study population. Settings and Design: The cross-sectional study conducted in the geriatric outpatient department of a tertiary care hospital...
October 2018: Indian Journal of Palliative Care
Elizabeth Åhsberg
INTRODUCTION: Despite a generally decreased length of stay in Swedish hospitals, an increasing delay of discharge has been observed among patients with long-term care need. AIM: Identify challenges and opportunities in the transition of patients between hospitals and out-patient care. METHOD: Data were obtained from national registers on patients discharged from hospitals in 2014, interviews with public care authorities, and a systematic literature review...
November 8, 2018: Scandinavian Journal of Caring Sciences
Anna Maria Meyer, Ingrid Becker, Giacomo Siri, Paul Thomas Brinkkötter, Thomas Benzing, Alberto Pilotto, M Cristina Polidori
BACKGROUND: The multidimensional prognostic index (MPI) is a validated, sensitive, and specific prognosis estimation tool based on a comprehensive geriatric assessment (CGA). The MPI accurately predicts mortality after 1 month and 1 year in older, multimorbid patients with acute disease or relapse of chronic conditions. OBJECTIVE: To evaluate whether the MPI predicts indicators of healthcare resources, i.e. grade of care (GC), length of hospital stay (LHS) and destination after hospital discharge in older patients in an acute medical setting...
November 7, 2018: Zeitschrift Für Gerontologie und Geriatrie
Daniel K Y Chan, Frank X Liu, Deni Irwanto, Davin Prasetyo, Gerard Ozorio, Feika Li, Matthew Smith, Anurag Sharma, Jack Chen
To share our experience of establishing an acute outreach service to nursing homes and to evaluate the impact of such service on emergency department presentations, data were drawn from a pre-existing database from 2013 to 2017. Of the 986 acute patients treated in 12 nursing homes over a 23-month period, the acute geriatric outreach service was shown to be safe, with few adverse events (one allergic reaction) and 5.3% of patients required transfer to hospital. The acute service decreased emergency department presentation of nursing home patients by 10% compared to the subacute service (incidence rate ratio = 0...
November 2018: Internal Medicine Journal
Kah Poh Loh, Erika Ramsdale, Eva Culakova, Jason H Mendler, Jane L Liesveld, Kristen M O'Dwyer, Colin McHugh, Maxence Gilles, Terri Lloyd, Molly Goodman, Heidi D Klepin, Karen M Mustian, Rebecca Schnall, Supriya G Mohile
BACKGROUND: Older patients with cancer are at an increased risk of adverse outcomes. A geriatric assessment (GA) is a compilation of reliable and validated tools to assess domains that are predictors of morbidity and mortality, and it can be used to guide interventions. However, the implementation of GA and GA-driven interventions is low due to resource and time limitations. GA-driven interventions delivered through a mobile app may support the complex needs of older patients with cancer and their caregivers...
October 29, 2018: JMIR Cancer
Scott L Hummel, Wahida Karmally, Brenda W Gillespie, Stephen Helmke, Sergio Teruya, Joanna Wells, Erika Trumble, Omar Jimenez, Cara Marolt, Jeffrey D Wessler, Maria L Cornellier, Mathew S Maurer
Background In patients with heart failure (HF), malnutrition and dietary sodium excess are common and may worsen outcomes. No prior studies have provided low-sodium, nutritionally complete meals following HF hospitalization. Methods and Results The GOURMET-HF study (Geriatric Out-of-Hospital Randomized Meal Trial in Heart Failure) randomized patients discharged from HF hospitalization to 4 weeks of home-delivered sodium-restricted Dietary Approaches to Stop Hypertension meals (DASH/SRD; 1500 mg sodium/d) versus usual care...
August 2018: Circulation. Heart Failure
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
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