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Geriatric Emergency

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https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#1
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29212411/geriatric-traumatic-brain-injury-epidemiology-outcomes-knowledge-gaps-and-future-directions
#2
Raquel C Gardner, Kristen Dams-O'Connor, Molly Rose Morrissey, Geoffrey Manley
This review of the literature on traumatic brain injury (TBI) in older adults focuses on incident TBI sustained in older adulthood ("geriatric TBI") rather than on the separate, but related, topic of older adults with a history of earlier-life TBI. We describe the epidemiology of geriatric TBI, the impact of comorbidities and pre-injury function on TBI risk and outcomes, diagnostic testing, management issues, outcomes, and critical directions for future research. The highest incidence of TBI-related emergency department visits, hospitalizations, and deaths occur in older adults...
December 6, 2017: Journal of Neurotrauma
https://www.readbyqxmd.com/read/29205261/report-and-research-agenda-of-the-american-geriatrics-society-and-national-institute-on-aging-bedside-to-bench-conference-on-urinary-incontinence-in-older-adults-a-translational-research-agenda-for-a-complex-geriatric-syndrome
#3
Camille P Vaughan, Alayne D Markland, Phillip P Smith, Kathryn L Burgio, George A Kuchel
The American Geriatrics Society, with support from the National Institute on Aging and other funders, held its ninth Bedside-to-Bench research conference, entitled "Urinary Incontinence in the Older Adult: A Translational Research Agenda for a Complex Geriatric Syndrome," October 16 to 18, 2016, in Bethesda, Maryland. As part of a conference series addressing three common geriatric syndromes-delirium, sleep and circadian rhythm disturbance, and urinary incontinence-the series highlighted relationships and pertinent clinical and pathophysiological commonalities between these conditions...
December 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29204845/six-month-emergency-department-use-among-older-adults-following-jail-incarceration
#4
Jessi Humphreys, Cyrus Ahalt, Irena Stijacic-Cenzer, Eric Widera, Brie Williams
Although the number of older adults who are arrested and subject to incarceration in jail is rising dramatically, little is known about their emergency department (ED) use or the factors associated with that use. This lack of knowledge impairs the ability to design evidence-based approaches to care that would meet the needs of this population. This 6-month longitudinal study aimed to determine the frequency of 6-month ED use among 101 adults aged 55 or older enrolled while in jail and to identify factors associated with that use...
December 4, 2017: Journal of Urban Health: Bulletin of the New York Academy of Medicine
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#5
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29203118/emerging-trends-in-undergraduate-medical-education-implications-for-geriatric-psychiatry
#6
EDITORIAL
Kirsten M Wilkins, Deborah Wagenaar, William B Brooks
No abstract text is available yet for this article.
November 7, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/29190544/the-contribution-of-occupational-factors-on-frailty
#7
REVIEW
Ivo Iavicoli, Veruscka Leso, Matteo Cesari
INTRODUCTION: Frailty is a clinical condition characterized by enhanced vulnerability to stressors and increased risk of developing dependency and/or mortality. It has been described as the multidimensional and dynamic condition that cannot be easily disentangled from psychosocial determinants. To date, the possible role of occupational factors on frailty development and its progression at advanced age are not yet fully understood. The aim of this work is to provide a comprehensive overview of existing evidence exploring the relationship between multiple occupational issues (e...
November 22, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29188912/-perfil-de-riesgo-y-an%C3%A3-lisis-comparativo-de-los-errores-de-conciliaci%C3%A3-n-de-medicamentos-seg%C3%A3%C2%BAn-el-m%C3%A3-dico-prescriptor-y-la-herramienta-de-prescripci%C3%A3-n
#8
Cristina Bilbao Gómez-Martino, Ángel Nieto Sánchez, Cristina Fernández Pérez, Mª Isabel Borrego Hernando, Francisco Javier Martín-Sánchez
OBJECTIVES: To study the frequency of medication reconciliation errors (MREs) in hospitalized patients and explore the profiles of patients at greater risk. To compare the rates of errors in prescriptions written by emergency physicians and ward physicians, who each used a different prescribing tool. MATERIAL AND METHODS: Prospective cross-sectional study of a convenience sample of patients admitted to medical, geriatric, and oncology wards over a period of 6 months...
2017: Emergencias: Revista de la Sociedad Española de Medicina de Emergencias
https://www.readbyqxmd.com/read/29188412/drug-related-problems-identified-during-geriatric-medication-review-in-the-community-pharmacy
#9
Mounir Rhalimi, Alain Rauss, Eric Housieaux
Background In line with the changing role of community pharmacists, we describe here a standardised procedure for detecting DRPs in elderly patients for use in community pharmacies. Objectives The primary aim was to describe the number and type of DRPs identified by community pharmacists in elderly patients. Secondary aims were to determine the number and type of associated pharmacist interventions (PIs) that were transmitted to the prescribers, and to identify risk factors associated with the occurrence of a PI...
November 29, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29186782/forging-a-frailty-ready-healthcare-system-to-meet-population-ageing
#10
(no author information available yet)
The beginning of the 21st century has seen health systems worldwide struggling to deliver quality healthcare amidst challenges posed by ageing populations. The increasing prevalence of frailty with older age and accompanying complexities in physical, cognitive, social and psychological dimensions renders the present modus operandi of fragmented, facility-centric, doctor-based, and illness-centered care delivery as clearly unsustainable. In line with the public health framework for action in the World Health Organization's World Health and Ageing Report, meeting these challenges will require a systemic reform of healthcare delivery that is integrated, patient-centric, team-based, and health-centered...
November 24, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29184448/older-adults-and-high-risk-medication-administration-in-the-emergency-department
#11
Mitchell Kim, Steven H Mitchell, Medley Gatewood, Katherine A Bennett, Paul R Sutton, Carol A Crawford, Itay Bentov, Mamatha Damodarasamy, Stephen J Kaplan, May J Reed
Background: Older adults are susceptible to adverse effects from opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), and benzodiazepines (BZDs). We investigated factors associated with the administration of elevated doses of these medications of interest to older adults (≥65 years old) in the emergency department (ED). Patients and methods: ED records were queried for the administration of medications of interest to older adults at two academic medical center EDs over a 6-month period...
2017: Drug, Healthcare and Patient Safety
https://www.readbyqxmd.com/read/29184319/a-comparative-study-of-depression-and-associated-risk-factors-among-elderly-inmates-of-old-age-homes-and-community-of-rajkot-a-gujarati-version-of-the-geriatric-depression-scale-short-form-gds-g
#12
Dipeshkumar D Zalavadiya, Anupam Banerjee, Ankit M Sheth, Matib Rangoonwala, Aarohi Mitra, Amiruddin M Kadri
Background: The prevalence of depression among elderly people varies across different setups such as old age homes (OAHs), community, and medical clinics. Aims: The aim of this study was to compare the epidemiological factors pertaining to depression among elderly residents of OAHs and community, using a new Gujarati version of the Geriatric Depression Scale-Short Form (GDS-G). Settings and Design: A cross-sectional, epidemiological study conducted in an urban setup of Western India...
October 2017: Indian Journal of Community Medicine
https://www.readbyqxmd.com/read/29180856/effects-of-comprehensive-geriatric-assessment-on-physical-fitness-in-an-acute-medical-setting-for-frail-elderly-patients
#13
Kristina Åhlund, Maria Bäck, Birgitta Öberg, Niklas Ekerstad
Introduction: Frail elderly people often use emergency care. During hospitalization, physical decline is common, implying an increased risk of adverse health outcomes. Comprehensive Geriatric Assessment (CGA) has been shown to be beneficial for these patients in hospital care. However, there is very limited evidence about the effects on physical fitness. The aim was to compare effects on physical fitness in the acute care of frail elderly patients at a CGA unit versus conventional care, 3 months after discharge...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29179708/comparing-doctors-legal-compliance-across-three-australian-states-for-decisions-whether-to-withhold-or-withdraw-life-sustaining-medical-treatment-does-different-law-lead-to-different-decisions
#14
Ben P White, Lindy Willmott, Colleen Cartwright, Malcolm Parker, Gail Williams, Juliet Davis
BACKGROUND: Law purports to regulate end-of-life care but its role in decision-making by doctors is not clear. This paper, which is part of a three-year study into the role of law in medical practice at the end of life, investigates whether law affects doctors' decision-making. In particular, it considers whether the fact that the law differs across Australia's three largest states - New South Wales (NSW), Victoria and Queensland - leads to doctors making different decisions about withholding and withdrawing life-sustaining treatment from adults who lack capacity...
November 28, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/29179627/delirium-is-associated-with-increased-mortality-in-the-geriatric-population
#15
Pinar Tosun Tasar, Sevnaz Sahın, Nur Ozge Akcam, Cıgdem Dınckal, Merve Gulsah Ulusoy, Ozan Fatih Sarıkaya, Soner Duman, Fehmi Akcıcek, Aysin Noyan
OBJECTIVE: The aim of this study was to investigate the prevalence of delirium and its association with mortality rates in elderly inpatients. METHODS: The medical records of 1435 patients over 65 years old who were treated at a regional university hospital and were referred to the university's Consultation and Liaison Psychiatry Clinic for psychological evaluation were retrospectively analyzed. Patients with and without a diagnosis of delirium were compared. The National Survival Database was used to determine mortality rates...
November 27, 2017: International Journal of Psychiatry in Clinical Practice
https://www.readbyqxmd.com/read/29177470/impaired-cognition-is-associated-with-adverse-outcome-in-older-patients-in-the-emergency-department-the-acutely-presenting-older-patients-apop-study
#16
J A Lucke, J de Gelder, C Heringhaus, R C van der Mast, A J Fogteloo, S Anten, G J Blauw, B de Groot, S P Mooijaart
Objective: to investigate whether cognitive impairment, measured early after Emergency Department (ED) arrival and irrespective of its cause, is independently associated with functional decline or mortality after 3 and 12 months in older ED patients. Design and setting: a prospective multi-centre cohort study in all Acutely Presenting Older Patients visiting the Emergency Department (APOP study) of three hospitals in the Netherlands. Participants: 2,130 patients, ≥70 years...
November 21, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29170333/36%C3%A2-frailty-flying-squad-an-emergency-department-focussed-acute-care-of-the-elderly-service-dr-genevieve-robson-royal-united-hospital-nhs-foundation-trust
#17
Samantha Ballham, Scott Buxton, Rosa Camacho, Adrianna Sinclair, Chris Dyer, Nicola Jakeman
INTRODUCTION: The over 75 s make up 20% of our ED attendances. The greatest increase has been in the over 85 s. This very elderly cohort are more likely to be frail and are 10X more likely to require admission than 20-40 year olds and once in hospital have longer stays. There is evidence that multidisciplinary care and early Comprehensive Geriatric Assessment (CGA) improves outcomes for older patients, reducing readmissions, long term care, greater satisfaction and lower costs. The aim of this project was to improve the acute care provided to our older patients at the Front Door of the hospital...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29165543/identification-of-older-adults-with-frailty-in-the-emergency-department-using-a-frailty-index-results-from-a-multinational-study
#18
Audrey-Anne Brousseau, Elsa Dent, Ruth Hubbard, Don Melady, Marcel Émond, Éric Mercier, Andrew P Costa
Objective: frailty is a central concept in geriatric medicine, yet its utility in the Emergency Department (ED) is not well understood nor well utilised. Our objectives were to develop an ED frailty index (FI-ED), using the Rockwood cumulative deficits model and to evaluate its association with adverse outcomes. Method: this was a large multinational prospective cohort study using data from the interRAI Multinational Emergency Department Study. The FI-ED was developed from the Canadian cohort and validated in the multinational cohort...
November 20, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29156247/humor-doesn-t-retire-improvisation-as-a-health-promoting-intervention-for-older-adults
#19
Lucy A Morse, Linda Xiong, Vanessa Ramirez-Zohfeld, Seltzer Anne, Becca Barish, Lee A Lindquist
As our population ages and aging in place continues to remain a priority of older adults, identifying novel ways to promote the wellbeing of older adults and reduce isolation is of the utmost importance. The Second City is a Chicago-based comedy improvisation organization that provides training in improvisation. One of their training courses, Humor Doesn't Retire, specifically teaches adults 55 and over, on improvisation. This study sought to explore the experiences of older adults enrolled in Humor Doesn't Retire, and to characterize any benefits that older adult participants perceived following participation in the comedy improvisation course...
October 28, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/29133497/comparative-associations-between-measures-of-anti-cholinergic-burden-and-adverse-clinical-outcomes
#20
Wen-Han Hsu, Yu-Wen Wen, Liang-Kung Chen, Fei-Yuan Hsiao
PURPOSE: No consensus has been reached regarding which anticholinergic scoring system works most effectively in clinical settings. The aim of this population-based cohort study was to examine the association between anticholinergic medication burden, as defined by different scales, and adverse clinical outcomes among older adults. METHODS: From Taiwan's Longitudinal Health Insurance Database, we retrieved data on monthly anticholinergic drug use measured by the Anticholinergic Risk Scale (ARS), the Anticholinergic Cognitive Burden Scale (ACB), and the Drug Burden Index - Anticholinergic component (DBI-Ach) for 116,043 people aged 65 years and older during a 10-year follow-up...
November 2017: Annals of Family Medicine
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