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Geriatric care management

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https://www.readbyqxmd.com/read/28914366/geriatric-assessment-with-management-intervention-in-older-adults-with-cancer-a-randomized-pilot-study
#1
Allison Magnuson, Tatyana Lemelman, Chintan Pandya, Molly Goodman, Marcus Noel, Mohammed Tejani, David Doughtery, William Dale, Arti Hurria, Michelle Janelsins, Feng Vankee Lin, Charles Heckler, Supriya Mohile
BACKGROUND: Older adults receiving cancer therapy have heightened risk for treatment-related toxicity. Geriatric assessment (GA) can identify impairments, which may contribute to vulnerability and adverse outcomes. GA management interventions can address these impairments and have the potential to improve outcomes when implemented. METHODS: We conducted a randomized pilot study comparing GA with management interventions versus usual care in patients with stage III/IV solid tumor malignancies (N = 71)...
September 15, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28890165/reduction-of-the-anticholinergic-burden-makes-it-possible-to-decrease-behavioral-and-psychological-symptoms-of-dementia
#2
Yacine Jaïdi, Vignon Nonnonhou, Lukshe Kanagaratnam, Laurie Anne Bertholon, Sarah Badr, Vivien Noël, Jean-Luc Novella, Rachid Mahmoudi
OBJECTIVE: The aim of this study was to evaluate the impact of a reduction of the anticholinergic burden (AB) on the frequency and severity of behavioral and psychological symptoms of dementia (BPSD) and their repercussions on the care team (occupational disruptiveness). METHODS: In this prospective, single-center study in an acute care unit for Alzheimer disease (AD) and related disorders, 125 elderly subjects (mean age: 84.4 years) with dementia presented with BPSD...
August 14, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28888556/telehealth-in-older-adults-with-cancer-in-the-united-states-the-emerging-use-of-wearable-sensors
#3
REVIEW
John Shen, Arash Naeim
As the aging and cancer populations in the world continue to increase, the need for complements to traditional geriatric assessments and the logical incorporation of fast and reliable telehealth tools have become interlinked. In the United States, studies examining the use of telehealth for chronic disease management have shown promising results in small groups. The implementation of health technology on a broader scale requires older adults to both accept and adapt such innovation into routine medical care...
September 6, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28880484/health-checkup-behavior-and-individual-health-beliefs-in-older-adults
#4
Mika Okura, Mihoko Ogita, Miki Yamamoto, Toshimi Nakai, Tomoko Numata, Hidenori Arai
AIM: Despite Japan being a developed nation, half of its older population does not attend regular health checkups. The aim of the present study was to examine the individual health beliefs and personal recommendations that strongly influence health checkup attendance among community-dwelling older adults. METHODS: In 2013, questionnaires were sent to 5401 community-dwelling older adults who were not receiving long-term institutionalized care. The response rate was 94...
September 7, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28873217/geriatrics-literature-2016-year-in-review
#5
Kaitlin Willham, Kenneth Covinsky, Eric Widera
We present 10 of the most effective articles from 2016 in geriatric medicine. They address wide-ranging topics including the use of antipsychotics for delirium in palliative care, fall prevention and mobility interventions, efficacy and potential risks of testosterone, cranberry capsules and their effect on bacteriuria and pyuria, beta-blockers after acute myocardial infarction in a nursing home population, the effect of a healthy lifestyle on disability, a goals-of-care intervention in individuals with advanced dementia, the benefits of regional anesthesia in hip repair, and mindfulness in chronic pain management...
September 5, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#6
Lauren Jan Gleason, Emily A Benton, M Loreto Alvarez-Nebreda, Michael J Weaver, Mitchel B Harris, Houman Javedan
OBJECTIVES: There are limited screening tools to predict adverse postoperative outcomes for the geriatric surgical fracture population. Frailty is increasingly recognized as a risk assessment to capture complexity. The goal of this study was to use a short screening tool, the FRAIL scale, to categorize the level of frailty of older adults admitted with a fracture to determine the association of each frailty category with postoperative and 30-day outcomes. DESIGN: Retrospective cohort study...
August 30, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28856791/predictors-on-admission-of-functional-decline-among-older-patients-hospitalised-for-acute-care-a-prospective-observational-study
#7
David Basic, Danielle Ní Chróinín, David Conforti, Chris Shanley
OBJECTIVE: We sought to investigate the incidence of, and factors associated with, in-hospital functional decline among older acute hospital patients. METHODS: We conducted a prospective observational study of consecutive patients admitted under geriatric medicine over 5 years. The primary outcome measure was functional decline between admission and discharge, representing deterioration in any of the following: Modified Barthel Index (MBI), independence in Timed Up and Go test or walking, and/or need for walking aid...
August 30, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28856665/discharge-plans-for-geriatric-inpatients-with-delirium-a-plan-to-stop-antipsychotics
#8
Kim G Johnson, Adedayo Fashoyin, Ramiro Madden-Fuentes, Andrew J Muzyk, Jane P Gagliardi, Mamata Yanamadala
BACKGROUND: Studies show inpatient geriatric patients with reversible conditions like delirium may continue on antipsychotic medications without clear indications after hospital discharge. We conducted this study to determine how often geriatric patients were discharged on a newly started antipsychotic during admission with a plan for discontinuation of the antipsychotic documented in the discharge summary. DESIGN: We conducted retrospective chart review identifying geriatric inpatients in our health system started on a new antipsychotic during admission...
August 30, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28854884/a-multi-center-randomized-controlled-trial-to-assess-the-efficacy-of-optimization-of-drug-prescribing-in-an-elderly-population-at-18%C3%A2-months-of-follow-up-in-the-evolution-of-functional-autonomy-the-optim-study-protocol
#9
Virginie Dauphinot, Elodie Jean-Bart, Pierre Krolak-Salmon, Christelle Mouchoux
BACKGROUND: Pharmacotherapy is necessary for the management of many diseases which number increased with aging. However, potentially inappropriate prescriptions and polymedication increases iatrogenic risks and can lead to adverse events. To limit the consequences of potentially harmful prescriptions, optimization of drug prescribing is a major stake of improving quality and safety of care in the elderly. The purpose of the OPTIM study is to study the impact of the optimization of drug prescribing on the evolution of functional autonomy at 18 months of follow-up...
August 30, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28852954/pressure-ulcers-are-associated-with-6-month-mortality-in-elderly-patients-with-hip-fracture-managed-in-orthogeriatric-care-pathway
#10
Emmanuelle Magny, Helene Vallet, Judith Cohen-Bittan, Mathieu Raux, Antony Meziere, Marc Verny, Bruno Riou, Frédéric Khiami, Jacques Boddaert
Despite orthogeriatric management, 12% of the elderly experienced PUs after hip fracture surgery. PUs were significantly associated with a low albumin level, history of atrial fibrillation coronary artery disease, and diabetes. The risk ratio of death at 6 months associated with pressure ulcer was 2.38 (95% CI 1.31-4.32%, p = 0.044). INTRODUCTION: Pressure ulcers in hip fracture patients are frequent and associated with a poor outcome. An orthogeriatric management, recommended by international guidelines in hip fracture patients and including pressure ulcer prevention and treatment, could influence causes and consequences of pressure ulcer...
August 29, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/28852239/physical-comorbidity-and-its-impact-on-symptom-profile-of-depression-among-elderly-patients-attending-psychiatry-services-of-a-tertiary-care-hospital
#11
Sandeep Grover, Eish Dalla, Aseem Mehra, Subho Chakrabarti, Ajit Avasthi
AIM: This study aimed to evaluate the prevalence of physical comorbidities among elderly patients with depression attending psychiatric services and the secondary aim of the study was to evaluate the influence of physical comorbidities on symptom profile of depression. METHODOLOGY: 140 patients with a diagnosis of depression as per the International Classification of Diseases-10 criteria were evaluated on Geriatric Depression Scale (GDS) and a physical comorbidity checklist...
July 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28851511/polypharmacy-potentially-inappropriate-medications-and-drug-drug-interactions-in-geriatric-patients-with-hematologic-malignancy-observational-single-center-study-of-122-patients
#12
David Y Leger, Stephane Moreau, Nicolas Signol, Jean-Baptiste Fargeas, Marie-Agnès Picat, Amélie Penot, Julie Abraham, Marie-Laure Laroche, Dominique Bordessoule
OBJECTIVES: Geriatric patients with hematologic malignancies (HMs) are prescribed targeted and supportive care treatments that add to the preexisting polypharmacy (PP). PP is associated with an increased risk of potentially inappropriate medications (PIM) and drug-drug interactions (DDI) resulting in increased hospitalization and mortality in the elderly. As very few data exist on these medication issues in the context of HMs, the objective of this study was to evaluate prevalence of PP, DDI and PIM use at baseline and 3months among elderly patients with HMs who received baseline geriatric assessment...
August 26, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28832897/reliability-of-an-online-geriatric-assessment-procedure-using-the-interrai-acute-care-assessment-system
#13
Melinda G Martin-Khan, Helen Edwards, Richard Wootton, Steven R Counsell, Paul Varghese, Wen Kwang Lim, Peteris Darzins, Lucy Dakin, Kerenaftali Klein, Leonard C Gray
OBJECTIVES: To determine whether geriatric triage decisions made using a comprehensive geriatric assessment (CGA) performed online are less reliable than face-to-face (FTF) decisions. DESIGN: Multisite noninferiority prospective cohort study. Two specialist geriatricians assessed individuals sequentially referred for an acute care geriatric consultation. Participants were allocated to one FTF assessment and an additional assessment (FTF or online (OL)), creating two groups-two FTF (FTF-FTF, n = 81) or online and FTF (OL-FTF, n = 85)...
August 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28807456/post-hospitalization-experiences-of-older-adults-diagnosed-with-diabetes-it-was-daunting
#14
Jacqueline B La Manna, Angeline Bushy, Denise Gammonley
Multimorbidity combined with geriatric syndromes in older adults with diabetes exacerbate their risks for poor post-discharge outcomes. The purpose of this study was to examine self-described hospital-to-home transition challenges encountered by older adults with a diagnosis of diabetes within the first 30 days following discharge. The qualitative responses for this paper emerged from a larger mixed methods study (n = 96) in which participants provided free responses specifying transition challenges during follow-up telephone interviews on the 7th day (n = 67) and 30th day (n = 55) post-discharge...
August 11, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28807214/early-geriatric-consultation-increases-adherence-to-tqip-geriatric-trauma-management-guidelines
#15
Lauren T Southerland, Tanya R Gure, Daniel I Ruter, Michael M Li, David C Evans
BACKGROUND: The American College of Surgeons' Trauma Quality Improvement Program (TQIP) Geriatric Trauma Management Guidelines recommend geriatric consultation for injured older adults. However it is not known how or whether geriatric consultation improves compliance to these quality measures. METHODS: This study is a retrospective chart review of our institutional trauma databank. Adherence to quality measures was compared before and after implementation of specific triggers for geriatric consultation...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28779825/geriatric-urinary-incontinence
#16
REVIEW
Jessica A R Searcy
Urinary incontinence (UI) is an international problem, affecting a high percentage of geriatric women. Nurses caring for geriatric women of all ages should be aware of the problem of UI and familiarize themselves with the potential treatment options for these patients. This article focuses on the prevalence, burden, clinical application, and management recommendations for the different types of UI.
September 2017: Nursing Clinics of North America
https://www.readbyqxmd.com/read/28776066/-management-of-an-elderly-patient-in-the-emergency-room-at-the-end-of-life-a%C3%A2-medical-ethics-challenge
#17
G Michels, R Nies, S Ortmann, R Pfister, F Salomon
A 94-year-old patient with cardiogenic shock due to myocardial infarction was admitted via the emergency room. A coronary angiography and intensive care were requested. The need for care due to dementia was known. After case discussion in the interdisciplinary and multiprofessional treatment team, the decision for a palliative care concept in the form of symptom control was made in the emergency room, taking into account the patient's medical history, the current situation, and the presumed patient consent...
August 3, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28768325/estimating-risk-of-postsurgical-general-and-geriatric-complications-using-the-vespa-preoperative-tool
#18
Lillian Min, Karen Hall, Emily Finlayson, Michael Englesbe, William Palazzolo, Chiao-Li Chan, Hechuan Hou, Ashley Miller, Kathleen M Diehl
Importance: As greater numbers of older patients seek elective surgery, one approach to preventing postoperative complications is enhanced assessment of risks during preoperative evaluation. Objective: To determine whether a geriatric assessment tool can be implemented in a preoperative clinic and can estimate risk of postoperative complications. Design, Setting, and Participants: In this prospective cohort study, patients 70 years of age or older were assessed in a preoperative clinic for elective surgery from July 9, 2008, to January 5, 2011...
August 2, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28762377/fecal-incontinence-is-associated-with-mortality-among-older-adults-with-complex-needs-an-observational-cohort-study
#19
Hamish A Jamieson, Philip J Schluter, Juno Pyun, Ted Arnold, Richard Scrase, Rebecca Nisbet-Abey, Vincent Mor, Joanne M Deely, Len Gray
OBJECTIVES: Fecal incontinence (FI) is a problem in growing older populations. Validating a suspected association between FI and mortality in community dwelling older adults could lead to improved planning for and management of the increasing complex older population. In a large cohort of New Zealand older adults, we assessed the prevalence of FI, urinary incontinence (UI), combined FI and UI, and their associations with mortality. METHODS: This study consisted of a retrospective analysis of international standardized geriatric assessment-home care (InterRAI-HC) data from community-dwelling adults aged 65 years or older, who met the criteria required for the InterRAI-HC, having complex needs and being under consideration for residential care...
September 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28750909/thank-you-for-asking-exploring-patient-perceptions-of-barcode-medication-administration-identification-practices-in-inpatient-mental-health-settings
#20
Gillian Strudwick, Carrie Clark, Brittany McBride, Moshe Sakal, Kamini Kalia
BACKGROUND: Barcode medication administration systems have been implemented in a number of healthcare settings in an effort to decrease medication errors. To use the technology, nurses are required to login to an electronic health record, scan a medication and a form of patient identification to ensure that these correspond correctly with the ordered medications prior to medication administration. In acute care settings, patient wristbands have been traditionally used as a form of identification; however, past research has suggested that this method of identification may not be preferred in inpatient mental health settings...
September 2017: International Journal of Medical Informatics
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