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Services and geriatric patients

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https://www.readbyqxmd.com/read/28302066/geriatric-support-in-the-emergency-department-a-national-survey-in-belgium
#1
Els Devriendt, Isabelle De Brauwer, Lies Vandersaenen, Pieter Heeren, Simon Conroy, Benoit Boland, Johan Flamaing, Marc Sabbe, Koen Milisen
BACKGROUND: Older people in the emergency department (ED) represent a growing population and increasing proportion of the workload in the ED. This study investigated the support for frail older people in the ED, by exploring the collaboration between the geriatric services (GS) and the EDs in Belgian hospitals. METHODS: An electronic cross-sectional survey in all Belgian hospitals with an ED (n = 100) about care aspects, collaboration, education and infrastructure for older patients in the ED was collected...
March 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28292646/follow-up-of-elderly-patients-with-urogenital-cancers-evaluation-of-geriatric-care-needs-and-related-actions
#2
Silvio Monfardini, Sara Morlino, Riccardo Valdagni, Mario Catanzaro, Ardit Tafa, Barbara Bortolato, Giovanni Petralia, Elisa Bonetto, Elisa Villa, Stefano Picozzi, Maria Cristina Locatelli, Giuseppe Galetti, Andrea Millul, Yasmin Albanese, Elisa Bianchi, Claudia Panzarino, Francesca Gerardi, Ettore Beghi
OBJECTIVES: To investigate a comprehensive geriatric assessment (CGA) with subsequent investigation of healthcare patterns in older patients with urological cancers undergoing initial surgery or radiotherapy, to verify the usefulness of the incorporation of geriatric principles in future care plans. MATERIAL AND METHODS: This is a prospective cohort study. From November 2011 to March 2015, CGA was offered to all patients aged 70+ years treated with radiotherapy or surgery at seven tertiary centers...
March 11, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28285980/activities-function-and-health-related-quality-of-life-hrqol-of-older-adults-with-cancer
#3
Mackenzi Pergolotti, Allison M Deal, Grant R Williams, Ashley L Bryant, Jeannette T Bensen, Hyman B Muss, Bryce B Reeve
OBJECTIVE: This study aims to (1) describe the activities, function, and health-related quality of life (HRQOL) of a large sample of older adults (age ≥65) with cancer, (2) identify the associations with demographics, cancer type, comorbid conditions, and ability to participate in activities and functional status. MATERIALS AND METHODS: The Health Registry/Cancer Survivorship Cohort is an institutional database designed to aid cancer survivorship research. The registry includes three measures of patient-reported HRQOL: FACT-G and PROMIS® Global measures for physical and mental health...
March 9, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28276179/effect-of-caregiving-relationship-and-formal-long-term-care-service-use-on-caregiver-well-being
#4
Kirsten Eom, Michael J Penkunas, Angelique W M Chan
AIM: Despite efforts to revise the traditional long-term care (LTC) model, informal caregivers continue to provide a substantial amount of support to older adults as front-line care providers. The present study aimed to understand the effect of informal caregiving on caregivers' well-being in Singapore with respect to different types of patient-caregiver relationships. Second, this study examined the association between formal LTC service use and caregivers' well-being. METHODS: Two waves of data for 781 dyads of patients with LTC needs and their caregivers from a longitudinal study were analyzed...
March 9, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28270122/implementation-of-integrated-geriatric-care-at-a-german-hospital-a-case-study-to-understand-when-and-why-beneficial-outcomes-can-be-achieved
#5
Loraine Busetto, Jörn Kiselev, Katrien Ger Luijkx, Elisabeth Steinhagen-Thiessen, Hubertus Johannes Maria Vrijhoef
BACKGROUND: Many health systems have implemented integrated care as an alternative approach to health care delivery that is more appropriate for patients with complex, long-term needs. The objective of this article was to analyse the implementation of integrated care at a German geriatric hospital and explore whether the use of a "context-mechanisms-outcomes"-based model provides insights into when and why beneficial outcomes can be achieved. METHODS: We conducted 15 semi-structured interviews with health professionals employed at the hospital...
March 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28253468/variation-in-outpatient-consultant-physician-fees-in-australia-by-specialty-and-state-and-territory
#6
Gary L Freed, Amy R Allen
OBJECTIVES: To determine the mean, median and 10th and 90th percentile levels of fees and out-of-pocket costs to the patient for an initial consultation with a consultant physician; to determine any differences in fees and bulk-billing rates between specialties and between states and territories. DESIGN, PARTICIPANTS AND SETTING: Analysis of 2015 Medicare claims data for an initial outpatient appointment with a consultant physician (Item 110) in 11 medical specialties representative of common adult non-surgical medical care (cardiology, endocrinology, gastroenterology, geriatric medicine, haematology, immunology/allergy, medical oncology, nephrology, neurology, respiratory medicine and rheumatology)...
March 6, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28223789/the-determinants-of-coping-with-pain-in-chronically-ill-geriatric-patients-the-role-of-a-sense-of-coherence
#7
Anna Andruszkiewicz, Małgorzata Anna Basińska, Mirosława Felsmann, Mariola Banaszkiewicz, Alicja Marzec, Kornelia Kędziora-Kornatowska
BACKGROUND: Given the rising population of the elderly in modern societies, the concern for their good functioning poses a challenge for the 21st century medicine and social services. Senior citizens are at an increased risk of developing chronic conditions, which in turn increase discomfort associated with physiological processes of aging. Sensations of pain have a particular influence on the mentioned discomfort, and pain is prevalent among older people. Therefore, from the perspective of an elderly person and senior care, it is crucial to identify determinants of effective coping with chronic pain...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28215922/early-postdischarge-stop-hf-clinic-reduces-30-day-readmissions-in-old-and-frail-patients-with-heart-failure
#8
Cristina Pacho, Mar Domingo, Raquel Núñez, Josep Lupón, Pedro Moliner, Marta de Antonio, Beatriz González, Javier Santesmases, Emili Vela, Jordi Tor, Antoni Bayes-Genis
INTRODUCTION AND OBJECTIVES: Heart failure (HF) is associated with a high rate of readmissions within 30 days postdischarge. Strategies to lower readmission rates generally show modest results. To reduce readmission rates, we developed a STructured multidisciplinary outpatient clinic for Old and frail Postdischarge patients hospitalized for HF (STOP-HF-Clinic). METHODS: This prospective all-comers study enrolled patients discharged from internal medicine or geriatric wards after HF hospitalization...
February 16, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28197663/-in-patient-early-rehabilitation
#9
Claus-W Wallesch, Sindy Lautenschläger
It is difficult to develop the financing and hospital provision of interventions for early rehabilitation within the diagnosis-related group (DRG) system. In addition to a range of partially rehabilitative complex interventions, the system recognizes three main forms of early rehabilitative interventions: geriatric, neurological/neurosurgical, and interdisciplinary and others. In this article, the appropriate definitions and cost-effectiveness of these procedures are analyzed and compared. The early rehabilitative interventions are characterized by constant cooperation in the therapeutic team, especially neurological early rehabilitation through the incorporation of nursing as a therapeutic profession...
February 14, 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/28196947/cohort-profile-the-welsh-geriatric-registrar-led-research-network-wegen-rationale-design-and-description
#10
Benjamin Jelley, Sara Long, John Butler, Jonathan Hewitt
PURPOSE: Medical trainees are required to undertake audit and quality improvement projects. They must also have an understanding of the principles of research and are encouraged to participate in research projects. However, the constraints of time, a lack of formal training and rotation between different training posts create barriers to audit cycle completion and pursuing research. This leads to trainees being reluctant to undertake research, facilitates poor quality research and risks incomplete audit...
February 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#11
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28195645/exploring-the-views-of-relatives-of-frail-elderly-patients-about-participating-in-a-geriatric-dentistry-program
#12
Diego Machado Ardenghi, Chris Wyatt
Elderly residents of long-term care facilities (LTC) have difficulty accessing dental services. Aiming to improve access for this population, the Geriatric Dental Program (GDP) was established by UBC Faculty of Dentistry in 2002. Within the GDP, elderly people receive fee-for-service dental care. The objective of this research was to explore whether accessing these services had an impact on the lives of the patients' relatives. Data was collected through semi-structured, face-to-face, audio-recorded interviews with family members of 12 GDP patients...
February 14, 2017: Special Care in Dentistry
https://www.readbyqxmd.com/read/28188966/where-to-go-if-not-the-hospital-reviewing-geriatric-bed-utilization-in-an-acute-care-hospital-in-singapore
#13
Ke Zhou, Arpana R Vidyarthi, Chek Hooi Wong, David Matchar
AIM: Singapore is one of the fastest-aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non-acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients. METHODS: We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore...
February 11, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#14
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28156664/association-between-anti-cholinergic-burden-and-delirium-among-patients-with-advanced-cancer-referred-to-a-palliative-care-consult-service
#15
Joseph Baidoo, Vishidha Reddy Balankari, Jessica Marie Waletich-Flemming, Marvin Delgado-Guay, Jimin Wu, Diane D Liu, Eduardo Bruera
213 Background: Delirium occurs in about 45-60% hospitalized patients and 80-85% at the end of life. Predisposing factors include anti-cholinergic medications as is often cited in the geriatric literature. Our study aimed to demonstrate the association of anti-cholinergic burden and delirium in patients with advanced cancer. METHODS: Retrospective review of 775 consecutive patients seen by the palliative care inpatient consult team. Demographic data, MDAS, ECOG, and anti-cholinergic drugs were determined...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28144397/pancreatic-resection-in-very-elderly-patients-a-critical-analysis-of-existing-evidence
#16
REVIEW
Cosimo Sperti, Lucia Moletta, Gioia Pozza
The aging of the population results in a rise of number of elderly patients (aged 80 years and older) with pancreatic or periampullary cancer, and more pancreatectomies could eventually be performed in such complex patients. However, early and long-term results after pancreatic resection in octogenarians are still controversial, and may trouble the surgeon when approaching this type of population. Evaluation of reported experiences shows that for almost all Authors, pancreatectomy can be performed safely in elderly population, although overall morbidity and mortality rates were 34...
January 15, 2017: World Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28143626/cognition-and-adaptive-functioning-in-older-people-attending-drug-and-alcohol-services
#17
L A Monds, N J Ridley, C Rivas, A Withall, B Draper, N Lintzeris
BACKGROUND: Substance use disorders in older adults are expected to increase dramatically in the coming years. Given the increased susceptibility to cognitive deficits in older substance users (defined here as aged 50+ years due to the accelerated health decline observed in this population), it is important to consider the functional correlates of cognitive impairment in these older adults. This study details the cognitive status of older individuals attending outpatient drug and alcohol (D&A) treatment services and seeks to determine of the association of cognitive impairment to self-reported daily functioning...
February 1, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28130953/primary-care-collaborative-memory-clinics-building-capacity-for-optimized-dementia-care
#18
Linda Lee, Loretta M Hillier, Frank Molnar, Michael J Borrie
Increasingly, primary care collaborative memory clinics (PCCMCs) are being established to build capacity for person-centred dementia care. This paper reflects on the significance of PCCMCs within the system of care for older adults, supported with data from ongoing evaluation studies. Results highlight timelier access to assessment with a high proportion of patients being managed in primary care within a person-centred approach to care. Enhancing primary care capacity for dementia care with interprofessional and collaborative care will strengthen the system's ability to respond to increasing demands for service and mitigate the growth of wait times to access geriatric specialist assessment...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28125847/-health-insurance-in-old-age-and-differences-in-cognition-depressive-symptoms-and-health-related-quality-of-life
#19
Jens-Oliver Bock, André Hajek, Dagmar Lühmann, Annette Ernst, Silke Mamone, Birgitt Wiese, Siegfried Weyerer, Jochen Werle, Michael Pentzek, Angela Fuchs, Janine Stein, Tobias Luck, Horst Bickel, Dagmar Weeg, Michael Wagner, Martin Scherer, Steffi G Riedel-Heller, Wolfgang Maier, Hans-Helmut König
Objective We aimed at identifying differences regarding cognition, depressive symptoms and health-related quality of life between members of private and statutory health insurance (SHI) in very old age in Germany. Methods Cross-sectional data were gathered from the multicenter prospective "Study on Needs, health service use, costs and health-related quality of life in a large sample of oldest-old primary care patients (85+)" (AgeQualiDe), covering primary care patients aged ≥ 85 years (n = 854; with 773 members of SHI)...
January 26, 2017: Psychiatrische Praxis
https://www.readbyqxmd.com/read/28124100/-treatment-with-psychotropic-agents-in-patients-with-dementia-and-delirium-gap-between-guideline-recommendations-and-treatment-practice
#20
Walter Hewer, Christine Thomas
BACKGROUND AND OBJECTIVES: Psychiatric symptoms in dementia and delirium are associated with a substantially reduced quality of life of patients and their families and often challenging for professionals. Pharmacoepidemiological surveys have shown that, in particular, patients living in nursing homes receive prescriptions of psychotropic agents in significant higher frequency than recommended by current guidelines. This article focuses on a critical appraisal of this gap from the point of view of German healthcare services...
February 2017: Zeitschrift Für Gerontologie und Geriatrie
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