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Geriatric care management

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https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#1
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29785782/path-analysis-of-caregiver-characteristics-and-neuropsychiatric-symptoms-in-alzheimer-s-disease-patients
#2
Lais L Delfino, Ricardo S Komatsu, Caroline Komatsu, Anita L Neri, Meire Cachioni
AIM: To determine the direct and indirect relationships of sociodemographic, emotional and behavioral characteristics of family caregivers of Alzheimer's disease patients who have neuropsychiatric symptoms. METHODS: A total of 134 family caregivers answered a questionnaire with sociodemographic data, and questions regarding the context of care, Neuropsychiatric Inventory, Zarit Burden Interview, Dementia Management Strategies Scale and the Beck Depression Inventory...
May 22, 2018: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#3
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29782209/practical-assessment-and-management-of-vulnerabilities-in-older-patients-receiving-chemotherapy-asco-guideline-for-geriatric-oncology
#4
Supriya G Mohile, William Dale, Mark R Somerfield, Mara A Schonberg, Cynthia M Boyd, Peggy S Burhenn, Beverly Canin, Harvey Jay Cohen, Holly M Holmes, Judith O Hopkins, Michelle C Janelsins, Alok A Khorana, Heidi D Klepin, Stuart M Lichtman, Karen M Mustian, William P Tew, Arti Hurria
Purpose To provide guidance regarding the practical assessment and management of vulnerabilities in older patients undergoing chemotherapy. Methods An Expert Panel was convened to develop clinical practice guideline recommendations based on a systematic review of the medical literature. Results A total of 68 studies met eligibility criteria and form the evidentiary basis for the recommendations. Recommendations In patients ≥ 65 years receiving chemotherapy, geriatric assessment (GA) should be used to identify vulnerabilities that are not routinely captured in oncology assessments...
May 21, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29773355/pain-assessment-and-management-by-nurses-in-a-geriatric-setting-discrepancies-between-guidelines-and-documented-practice
#5
Irit Shahar, Gad Mendelson, Shlomit Gerbi, Merav Ben Natan
Pain is a common subjective symptom among older adults in general and among older adult residents in long-term geriatric facilities in particular. Pain diminishes older adults' quality of life and may impair their ability to recover from various illnesses. Therefore, the Israeli Ministry of Health has issued guidelines on effectively assessing and treating pain in this population. To examine discrepancies between the Ministry of Health's pain assessment guidelines and documented practice by nursing staff at a long-term geriatric care facility and whether these discrepancies correlate to characteristics of the nurses, the wards, and the patients' characteristics...
May 14, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29772281/geriatric-oncology-spirituality-and-palliative-care
#6
Lodovico Balducci
Cancer is a major cause of morbidity and mortality for older individuals. Palliative care is essential to improve the outcome of cancer treatment in terms of quality of life and treatment satisfaction. This review examines the influence of spirituality on aging in general and on the management of older cancer patients. A spiritual perspective has been associated with successful aging, and with better tolerance of physical and emotional stress, including the ability to cope with serious diseases and with isolation...
May 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29764248/interprofessional-collaboration-and-the-care-and-management-of-type-2-diabetic-patients-in-the-middle-east-a-systematic-review
#7
J M Johnson, R Carragher
The World Health Organization has ranked the Middle East (ME) as the second most prevalent region globally for type 2 diabetes. Currently, treatment options initiated by physicians focus mainly on pharmaceuticals; however, lifestyle factors also have a tremendous impact on a patient's wellness or illness. A potential solution to this issue is to use an interprofessional team approach when caring for this patient population. The purpose of this systematic review is to look at the present literature involving the use of an interprofessional team approach to the care and maintenance of people with type 2 diabetes in the ME...
May 15, 2018: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/29763754/determinants-of-cancer-treatment-and-mortality-in-older-cancer-patients-using-a-multi-state-model-results-from-a-population-based-study-the-incapac-study
#8
Angéline Galvin, Catherine Helmer, Gaëlle Coureau, Brice Amadeo, Pierre Joly, Camille Sabathé, Alain Monnereau, Isabelle Baldi, Muriel Rainfray, Pierre Soubeyran, Fleur Delva, Simone Mathoulin-Pélissier
INTRODUCTION: Several studies have reported disparities in the care management and survival of older cancer patients. The aim of our study was to identify determinants of treatment administration in this population of cancer patients aged over 65 years taking into account competing risks of death. METHODS: The INCAPAC study is a population-based study. Four cancer registries and three prospective cohort studies on older subjects (age ≥65 years) from Gironde, a French department, were merged to identify older cancer patients...
May 12, 2018: Cancer Epidemiology
https://www.readbyqxmd.com/read/29760025/association-of-the-social-determinants-of-health-with-quality-of-primary-care
#9
Alan Katz, Dan Chateau, Jennifer E Enns, Jeff Valdivia, Carole Taylor, Randy Walld, Scott McCulloch
PURPOSE: In primary care, there is increasing recognition of the difficulty of treating patients' immediate health concerns when their overall well-being is shaped by underlying social determinants of health. We assessed the association of social complexity factors with the quality of care patients received in primary care settings. METHODS: Eleven social complexity factors were defined using administrative data on poverty, mental health, newcomer status, and justice system involvement from the Manitoba Population Research Data Repository...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29755614/implant-treatment-in-ultra-aged-society
#10
REVIEW
Yuji Sato, Noboru Kitagawa, Akio Isobe
Implant therapy is gaining presence as a prosthodontic treatment option. However, the graying of the population has led to an increase in the number of older adults requiring special consideration in implant treatment because of their systemic health problems. Additionally, with the growth of the elderly population in need of long-term care, a greater number of older adults who have received implant treatment are receiving long-term care, raising various issues that need to be addressed. In the present review article, we describe the significance of implant treatment in older adults, issues when performing implant treatment in geriatric patients, and measures to be taken when implant patients have lapsed into a state of requiring long-term care...
May 2018: Japanese Dental Science Review
https://www.readbyqxmd.com/read/29748342/impact-investigating-the-impact-of-models-of-practice-for-allied-health-care-in-subacute-settings-a-protocol-for-a-quasi-experimental-mixed-methods-study-of-cost-effectiveness-and-outcomes-for-patients-exposed-to-different-models-of-allied-health-care
#11
Freya Coker, Cylie M Williams, Nicholas F Taylor, Kirsten Caspers, Fiona McAlinden, Anita Wilton, Nora Shields, Terry P Haines
INTRODUCTION: This protocol considers three allied health staffing models across public health subacute hospitals. This quasi-experimental mixed-methods study, including qualitative process evaluation, aims to evaluate the impact of additional allied health services in subacute care, in rehabilitation and geriatric evaluation management settings, on patient, health service and societal outcomes. METHODS AND ANALYSIS: This health services research will analyse outcomes of patients exposed to different allied health models of care at three health services...
May 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29747954/role-of-the-geriatrician-primary-care-practitioner-nurses-and-collaboration-with-oncologists-during-cancer-treatment-delivery-for-older-adults-a-narrative-review-of-the-literature
#12
Martine T E Puts, Fay J Strohschein, M Elisabeth Del Giudice, Rana Jin, Allison Loucks, Ana Patricia Ayala, Shabbir H M Alibhai
Cancer is a disease that mostly affects older adults. With the aging of the population there will be a considerable increase in the number of older adults with cancer. Optimal care of the older adult with cancer requires the involvement of many types of health care providers, including oncologists, nurses, primary care practitioners, and geriatricians. In this narrative review, the literature for evidence relating to the roles of and collaboration between geriatricians, primary care practitioners, nurses, and the oncology team during cancer treatment delivery to older adults was examined...
May 7, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29744236/brief-assessments-and-screening-for-geriatric-conditions-in-older-primary-care-patients-a-pragmatic-approach
#13
REVIEW
Laurence Seematter-Bagnoud, Christophe Büla
This paper discusses the rationale behind performing a brief geriatric assessment as a first step in the management of older patients in primary care practice. While geriatric conditions are considered by older patients and health professionals as particularly relevant for health and well-being, they remain too often overlooked due to many patient- and physician-related factors. These include time constraints and lack of specific training to undertake comprehensive geriatric assessment. This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status...
2018: Public Health Reviews
https://www.readbyqxmd.com/read/29741200/the-utility-of-the-frailty-index-in-clinical-decision-making
#14
K Khatry, N M Peel, L C Gray, R E Hubbard
Using clinical vignettes, this study aimed to determine if a measure of patient frailty would impact management decisions made by geriatricians regarding commonly encountered clinical situations. Electronic surveys consisting of three vignettes derived from cases commonly seen in an acute inpatient ward were distributed to geriatricians. Vignettes included patients being considered for intensive care treatment, rehabilitation, or coronary artery bypass surgery. A frailty index was generated through Comprehensive electronic Geriatric Assessment...
2018: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/29729050/staff-members-ambivalence-on-caring-for-patients-with-multidrug-resistant-bacteria-at-their-end-of-life-a-qualitative-study
#15
Johanna M Tiedtke, Stephanie Stiel, Maria Heckel, Franziska A Herbst, Alexander Sturm, Cornel Sieber, Christoph Ostgathe, Frieder R Lang
AIMS AND OBJECTIVES: To explore healthcare professionals' personal experiences, feelings, and attitudes about caring for hospitalized patients with multidrug-resistant bacteria in palliative and geriatric care. BACKGROUND: Working in end-of-life care involves at times burdening demands that affect not only healthcare professionals personally but also their actions. It is suggested that multidrug-resistant bacteria and their consequences for colonized or infected patients in hospitals are among the challenges for all professionals in end-of-life care...
May 5, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29714994/issues-in-geriatric-care-alzheimer-disease
#16
Kathy Kemle, Richard J Ackermann
Alzheimer disease (AD) occurs in 8.8% of older US adults and is the sixth leading cause of death among older adults. Medicare annual wellness visits require screening for cognitive impairment but do not specify screening methods. Numerous screening instruments are available. If results are positive, evaluation with well-validated assessment tools is needed. If cognitive impairment is confirmed, laboratory tests and imaging studies should be obtained to rule out reversible etiologies. If patients meet diagnostic criteria for AD, clinicians should educate patients and families on the expected course and help them complete advance directives...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29714993/issues-in-geriatric-care-falls
#17
Dipesh Patel, Richard J Ackermann
One in three older adults falls each year. There are approximately 2.5 million falls among older adults treated in emergency departments. Falls account for 87% of all fractures in this age group. The biggest risk factor for falling is a history of falls. Other risk factors include frailty, sedative and anticholinergic drugs, polypharmacy, and a variety of medical conditions. Current recommendations are that all patients age 65 years and older should be asked about falls each year. Patients also can be screened for fall risk with a variety of approaches including questionnaires and the Timed Up & Go test...
May 2018: FP Essentials
https://www.readbyqxmd.com/read/29704045/recommended-care-received-by-geriatric-hip-fracture-patients-where-are-we-now-and-where-are-we-heading
#18
Deborah Seys, An Sermon, Walter Sermeus, Massimiliano Panella, Luk Bruyneel, Paulo Boto, Kris Vanhaecht
INTRODUCTION: Despite the availability of clinical guidelines on the prevention and treatment of geriatric hip fractures, the percentage of recommended care received by patients is low. We conducted an importance-performance analysis for prioritizing interventions to improve the in-hospital management of these patients. MATERIALS AND METHODS: A secondary data analysis was conducted on the in-hospital treatment of 540 geriatric hip fracture patients in 34 hospitals in Belgium, Italy, and Portugal...
April 27, 2018: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/29699619/domain-management-approach-to-heart-failure-in-the-geriatric-patient-present-and-future
#19
REVIEW
Eiran Z Gorodeski, Parag Goyal, Scott L Hummel, Ashok Krishnaswami, Sarah J Goodlin, Linda L Hart, Daniel E Forman, Nanette K Wenger, James N Kirkpatrick, Karen P Alexander
Heart failure (HF) is a quintessential geriatric cardiovascular condition, with more than 50% of hospitalizations occurring in adults age 75 years or older. In older patients, HF is closely linked to processes inherent to aging, which include cellular and structural changes to the myocardium, vasculature, and skeletal muscle. In addition, HF cannot be considered in isolation of physical functioning, or without the social, psychological, and behavioral dimensions of illness. The role of frailty, depression, cognitive impairment, nutrition, and goals of care are each uniquely relevant to the implementation and success of medical therapy...
May 1, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#20
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
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