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Geriatric care management

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https://www.readbyqxmd.com/read/28631275/a-typology-of-interprofessional-teamwork-in-acute-geriatric-care-a-study-in-55-units-in-belgium
#1
Ruth D Piers, Karen J J Versluys, Johan Devoghel, Sophie Lambrecht, André Vyt, Nele J Van Den Noortgate
OBJECTIVES: To explore the quality of interprofessional teamwork in acute geriatric care and to build a model of team types. DESIGN: Cross-sectional multicenter study. SETTING: Acute geriatric units in Belgium. PARTICIPANTS: Team members of different professional backgrounds. MEASUREMENTS: Perceptions of interprofessional teamwork among team members of 55 acute geriatric units in Belgium were measured using a survey covering collaborative practice and experience, managerial coaching and open team culture, shared reflection and decision-making, patient files facilitating teamwork, members' belief in the power of teamwork, and members' comfort in reporting incidents...
June 20, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#2
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#3
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28602461/adapting-systems-of-care-for-people-aging-with-hiv
#4
Eugenia L Siegler, Mark Brennan-Ing
People aging with HIV have medical and psychosocial needs that require more than the HIV services network can provide. HIV providers may lack experience managing multimorbidity or the functional consequences of aging. Social support services may be unable to provide necessary services for people living with HIV (PLWH) who are becoming increasingly frail or facing cognitive impairment. HIV providers will be caring for aging PLWH whose HIV management may seem simple compared with the significant burdens of stigma, mental health needs, social isolation, multimorbidity, and aging-related syndromes...
May 26, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28602414/the-older-adult-with-locoregionally-advanced-head-and-neck-squamous-cell-carcinoma-knowledge-gaps-and-future-direction-in-assessment-and-treatment
#5
Ronald Maggiore, Zachary S Zumsteg, Karlynn BrintzenhofeSzoc, Kelly M Trevino, Ajeet Gajra, Beatriz Korc-Grodzicki, Joel B Epstein, Stewart M Bond, Ira Parker, Julie A Kish, Barbara A Murphy, Noam A VanderWalde
Older adults with head and neck squamous cell carcinoma (HNSCC) pose unique treatment and supportive care challenges to oncologists and other cancer care providers. The majority of patients with HNSCC present with locoregionally advanced disease, for which combined-modality treatment integrating chemotherapy and radiation therapy is often necessary to maximize tumor control. However, applying these approaches to an older population with concomitant comorbidities and a higher risk of functional impairments remains challenging and is exacerbated by the paucity of studies involving older adults...
July 15, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28595684/marijuana-use-in-the-elderly-implications-and-considerations
#6
Tracy D Mahvan, Michelle L Hilaire, Allison Mann, Antoinette Brown, Becky Linn, Taylor Gardner, Beryen Lai
OBJECTIVE: This article reviews the literature on the use of marijuana in the elderly. Pharmacists play an important role in the management of medications including drug use of potentially illegal drugs, including marijuana. The use of both recreational and medical marijuana has grown exponentially in the general population, including in older adults. As of 2017, marijuana for medical use is legal in 26 states and the District of Columbia. DATA SOURCES: PubMed and Internet search using the following terms: marijuana, cannabis, delta-9-tetrhydrocannabinol (THC), cannabidiol, cannabinoid, elderly, geriatric, and pharmacology...
June 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/28590144/pharmacological-treatment-of-depression-in-geriatric-chronic-pain-patients-a-biopsychosocial-approach-integrating-functional-restoration
#7
Peter Polatin, Kelley Bevers, Robert J Gatchel
A recent literature review concluded that the comorbidity of chronic pain and depression in adults is approximately 50%-65%. Physical and cognitive declines, concurrent multiple health conditions, and complex medication regimens add to the unique and complex challenges of effectively treating pain in particularly geriatric populations. Interdisciplinary medical intervention and monitoring for psychiatric sequelae, such as depression, cognitive change, and synergistic physical side effects are necessary. Areas covered: This review covers an extensive multi-database wide search of the pharmacotherapy of pain and depression in older adults, including biopsychosocial approaches...
June 14, 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28584740/impact-of-preoperative-echocardiography-on-perioperative-management-in-geriatric-hip-trauma-a-retrospective-observational-study
#8
Chhavi Sawhney, Vivek Trikha, Sai Janani, Sukhminder Jit Singh Bajwa, Vijay Sharma, Menaal Khanna
BACKGROUND AND AIM: Hip fractures are associated with a significant risk of morbidity and mortality in the elderly population. Current guidelines propose that these patients should be operated as early as possible. Preoperative cardiac investigations, especially echocardiography, have been considered to delay surgery with few changes in the patient management. The present study has been conducted to evaluate whether preoperative echocardiography improve or worsen the prognosis in such hip trauma surgery...
April 2017: International Journal of Applied and Basic Medical Research
https://www.readbyqxmd.com/read/28583833/profile-and-results-of-frail-patient-assessed-by-advanced-practice-nursing-in-an-emergency-department
#9
Montserrat Solé-Casals, Emilia Chirveches-Pérez, Emma Puigoriol-Juvanteny, Núria Nubó-Puntí, Carolina Chabrera-Sanz, Mireia Subirana-Casacuberta
OBJECTIVES: To describe the profile of patients evaluated by Nurse Care Management in an Emergency Department and identify the type of alternative healthcare resource assigned and report the results of clinical practice. MATERIAL AND METHODS: Prospective follow-up, on admission to the Emergency Department in an acute hospital and on discharge from the alternative healthcare resource, of patients assessed by Nurse Care Management, from July to December 2015. The patient characteristics, social environment and results of clinical practice were studied...
June 2, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28573900/initial-therapy-for-acute-myeloid-leukemia-in-older-patients-principles-of-care
#10
Vijaya Raj Bhatt, Krishna Gundabolu, Thuy Koll, Lori J Maness
Older patients with acute myeloid leukemia (AML) frequently have significant comorbidities, geriatric syndromes, and high-risk leukemia that make them susceptible to high early mortality, chemotherapy-related toxicities, and poor long-term survival. The receipt of chemotherapy or hematopoietic cell transplantation is low, and the choices between intensive or low-intensity chemotherapy is often not clear. Geriatric and multidisciplinary interventions targeted to optimize functional status and improve management of comorbidities may enhance chemotherapy tolerance...
June 2, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28561726/caring-for-the-older-population-with-advanced-lung-cancer
#11
Carolyn J Presley, Craig H Reynolds, Corey J Langer
The management of advanced lung cancer is changing rapidly, with new drug approvals occurring almost monthly. The average age of a newly diagnosed patient with advanced lung cancer remains around age 70. Caring for the older adult with advanced cancer differs from the care of younger adults. Chronologic age often does not accurately reflect the physiologic and functional status of older adults. Selecting treatment based on age alone results in undertreatment and overtreatment of many older adults. Addressing issues such as multiple chronic conditions, polypharmacy, geriatric syndromes, and heterogeneity in functional status among an expanding menu of treatment options for advanced disease is increasingly difficult, particularly among older adults historically underrepresented in clinical trials...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28557875/supporting-the-support-system-how-assessment-and-communication-can-help-patients-and-their-support-systems
#12
Jane Harkey, Jared Young, Jolynne Jo Carter, Michael Demoratz
PURPOSE/OBJECTIVE: The benefits of having a support system, such as social relationships with close friends and family, have been well documented for patients with serious health issues. As scientific evidence has shown, individuals who have the lowest level of involvement in social relationships face a greater mortality risk. Support systems, however, are not infallible. Relationship stress can have a negative impact on people-patient and caregiver alike-behaviorally, psychosocially, and physiologically...
July 2017: Professional Case Management
https://www.readbyqxmd.com/read/28556873/nurses-perceptions-and-management-of-urinary-incontinence-in-hospitalized-older-adults-an-integrative-review
#13
Marnie Colborne, Sherry Dahlke
Urinary incontinence (UI) is a geriatric syndrome affecting older adults in long-term and acute hospital care. Most research has focused on nurses' perceptions of UI in long-term care and community settings rather than acute hospital settings. The purpose of the current integrative review was to understand nurses' perceptions and use of continence strategies for hospitalized older adults. Literature published from 1996-2016 was reviewed. Critical appraisal of the articles by two researchers yielded 10 articles that described nine studies...
May 30, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28555704/transdisciplinary-research-in-frailty-knowledge-translation-to-inform-new-models-of-care
#14
M Archibald, A Kitson, D Frewin, R Visvanathan
Transforming care for frail older adults requires more than rigorous research. While preventing, identifying and managing frailty are critical to reducing the personal and health systems impact of frailty worldwide, collaborative approaches to research and research application that reflect stakeholder perspectives and priorities are necessary to create meaningful solutions to frailty-related challenges. In South Australia, a new Centre for Research Excellence in Frailty was recently launched with funding from the National Health and Medical Research Council of Australia...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28549592/economic-outcomes-of-pharmacist-physician-medication-therapy-management-for-polypharmacy-elderly-a-prospective-randomized-controlled-trial
#15
Hsiang-Wen Lin, Chih-Hsueh Lin, Chin-Kai Chang, Che-Yi Chou, I-Wen Yu, Cheng-Chieh Lin, Tsai-Chung Li, Chia-Ing Li, Yow-Wen Hsieh
BACKGROUND/PURPOSE: With an increasing geriatric population, the need for effective management of chronic conditions and medication use in the elderly is growing. Medication use in the elderly presents significant challenges due to changes in pharmacodynamic and pharmacokinetic profiles. We aimed to examine the impact of a collaborative physician-pharmacist medication therapy management (MTM) program for polypharmacy elderly patients. METHODS: Elderly patients with multiple chronic conditions on polypharmacy were enrolled in this prospective, randomized, and controlled study over 16 months of implementation...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28544166/clinical-features-of-extremely-elderly-patients-with-heart-failure
#16
Tetsuro Yokokawa, Akiomi Yoshihisa, Yuki Kanno, Takamasa Sato, Satoshi Suzuki, Tomofumi Misaka, Masayoshi Oikawa, Atsushi Kobayashi, Takayoshi Yamaki, Hiroyuki Kunii, Kazuhiko Nakazato, Hitoshi Suzuki, Shu-Ichi Saitoh, Yasuchika Takeishi
AIM: To investigate the clinical features of heart failure in extremely elderly patients. METHODS: We analyzed 1163 consecutive hospitalized heart failure patients. The patients were divided into an extremely elderly group (≥85 years-of-age, n = 88) and a non-extremely elderly group (<85 years-of-age, n = 1075). RESULTS: The extremely elderly group had higher rates of hypertension, chronic kidney disease, anemia, higher systolic blood pressure and lower body mass index, and lower use of β-blockers and anticoagulants compared with the non-extremely elderly group...
May 21, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28540117/orthogeriatric-combined-management-of-elderly-patients-with-proximal-femoral-fracture-results-of-a-1-year-follow-up
#17
Stefan Förch, Reiner Kretschmer, Thomas Haufe, Johannes Plath, Edgar Mayr
INTRODUCTION: According to the expected demographical changes, the number of elderly trauma patients will increase exponentially over the next decades. Different models of an interdisciplinary orthogeriatric care have been developed. But there is only limited evaluation of their benefit without clear and evidence-based results. In 2011, we monitored the results of our orthogeriatric combined management by conducting a 1-year follow-up. METHODS: We treated 231 patients presenting a proximal femoral fracture on our orthogeriatric ward...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28540113/comparison-of-3-different-perioperative-care-models-for-patients-with-hip-fractures-within-1-health-service
#18
Lillian Sarah Coventry, Austin Nguyen, Amalia Karahalios, Sasha Roshan-Zamir, Phong Tran
INTRODUCTION: Orthogeriatric care models have been introduced within many health-care facilities to improve outcomes for hip fracture patients. This study aims to evaluate differences in care between 3 models, an orthopedic model, a geriatric model, and a comanaged model. MATERIALS AND METHODS: A retrospective analysis was conducted for hip fracture patients treated at Western Health between November 2012 and March 2014. All patients aged 65 years or older were included in the analysis...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28537333/changes-in-nutritional-and-functional-status-in-longer-stay-patients-admitted-to-a-geriatric-evaluation-and-management-unit
#19
A Whitley, E Skliros, C Graven, R McIntosh, C Lasry, C Newsome, A Bowie
OBJECTIVES: Malnutrition and functional decline are common in older inpatients admitted to subacute care settings. However the association between changes in nutritional status and relevant functional outcomes remains under-researched. This study examined changes in nutritional status, function and mobility in patients admitted to a Geriatric Evaluation and Management (GEM) unit who had a length of stay (LOS) longer than 21 days. DESIGN: A prospective, observational study...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28537060/comprehensive-approach-for-managing-the-older-person-with-diabetes-mellitus
#20
REVIEW
Hyung Joon Yoo
Care of the elderly population with diabetes may not be restricted to the management of hyperglycemia, associated risk factors, and specific diabetic complications. An integrated approach should also include the assessment and management of gerontological problems. Both diabetes mellitus and aging interact toward the direction of the increased incidence of geriatric syndromes. Education is a common element of both diabetes control and geriatric syndrome care. However, it has been perceived that conventional education programs for diabetics are not as effective for the elderly...
May 18, 2017: Diabetes & Metabolism Journal
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