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Geriatrics Critical Care

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https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#1
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/28599140/instruments-to-evaluate-mobility-capacity-of-older-adults-during-hospitalization-a-systematic-review
#2
REVIEW
Karla Vanessa Rodrigues Soares Menezes, Claudine Auger, Weslley Rodrigues de Souza Menezes, Ricardo Oliveira Guerra
Independent mobility is a key factor in predicting morbidity and determining hospital discharge readiness for older patients. The main objective was identify and appraise relevant instruments for the measurement of mobility of hospitalized geriatric patients. A systematic review was performed in two consecutive steps. Based on the definition of mobility of the International Classification of Functioning (ICF). Step 1 identified mobility measurement instruments used to assess patients 60 years of age and over hospitalized in acute care or intensive geriatric rehabilitation unit...
May 27, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28556873/nurses-perceptions-and-management-of-urinary-incontinence-in-hospitalized-older-adults-an-integrative-review
#3
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
#4
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/28498197/overuse-of-health-care-services-in-the-management-of-cancer-a-systematic-review
#5
Shrujal S Baxi, Minal Kale, Salomeh Keyhani, Benjamin R Roman, Annie Yang, Antonio P Derosa, Deborah Korenstein
BACKGROUND: Overuse, the provision of health services for which harms outweigh the benefits, results in suboptimal patient care and may contribute to the rising costs of cancer care. We performed a systematic review of the evidence on overuse in oncology. METHODS: We searched Medline, EMBASE, the Cochrane Library, Web of Science, SCOPUS databases, and 2 grey literature sources, for articles published between December 1, 2011 and March 10, 2017. We included publications from December 2011 to evaluate the literature since the inception of the ABIM Foundation's Choosing Wisely initiative in 2012...
July 2017: Medical Care
https://www.readbyqxmd.com/read/28493647/the-liminality-of-the-patient-with-dementia-in-geriatric-rehabilitation-hospitals
#6
Robin Digby, Susan Lee, Allison Williams
AIM: The aim was to explore the experiences of people with dementia in sub-acute geriatric rehabilitation hospitals to critically evaluate the care received by such patients. BACKGROUND: Globally the number of people with dementia is growing and is expected to impact progressively more on health systems. People with dementia can become deconditioned and deteriorate in cognitive function while in hospital. The unfamiliar environment and people can cause the person to become disorientated which then leads to behavioural symptoms which complicate care...
May 11, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28471238/clinician-perceptions-about-inpatient-occupational-therapy-groups-in-traumatic-brain-injury-rehabilitation
#7
Freyr Patterson, Jennifer Fleming, Emmah Doig
PRIMARY OBJECTIVE: The aim of the study was to explore the experiences and perceptions of clinicians about the benefits, challenges and processes of facilitating inpatient occupational therapy groups in traumatic brain injury (TBI) rehabilitation including peer-to-peer interactions and use of goals. DESIGN AND METHOD: A qualitative methodology, guided by a phenomenological approach was utilized with data collected from focus groups comprising 26 clinicians working in occupational therapy in three inpatient rehabilitation settings: brain injury, spinal injury and geriatric rehabilitation in order to identify aspects unique to brain injury rehabilitation...
May 4, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/28432547/health-related-quality-of-life-and-diabetes-self-care-activity-in-elderly-patients-with-diabetes-in-korea
#8
Hacksun Kim, Kisook Kim
A critical goal in the management of elderly patients with diabetes is to improve their health-related quality of life (HRQOL). This study aimed to identify the factors affecting HRQOL in elderly Korean patients with diabetes. Participants were 365 elderly patients with diabetes who were treated in a general hospital in Korea. The data were analysed using independent t-tests, Pearson correlations, and stepwise multiple regression. The mean total HRQOL score was 74.77, and HRQOL showed positive correlations with activities of daily living (ADL), instrumental activities of daily living (IADL), and the Summary of Diabetes Self-care Activities (SDSA)...
April 21, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28419042/geriatric-fracture-care-future-trajectories-a-2015-aoa-critical-issues-symposium
#9
Julie A Switzer, Kevin J Bozic, Stephen L Kates
The population of the United States and the world is aging rapidly. Musculoskeletal care for older adults will be impacted by the manner in which health care is financed and the ability of the orthopaedic community to provide evidence-based integrated care for this population. We review the financial aspects of health-care reform and the implications for musculoskeletal care in the elderly. We discuss the establishment of quality measures for hip fracture care in the elderly, team building to accomplish this, and an innovative program designed to provide orthopaedic care to the frail elderly outside of the usual office setting...
April 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28418066/a-national-survey-on-the-effect-of-the-geriatric-academic-career-award-in-advancing-academic-geriatric-medicine
#10
Kevin T Foley, Clare C Luz, Katherine V Hanson, Yuning Hao, Elisia M Ray
A workforce that understands principles of geriatric medicine is critical to addressing the care needs of the growing elderly population. This will be impossible without a substantial increase in academicians engaged in education and aging research. Limited support of early-career clinician-educators is a major barrier to attaining this goal. The Geriatric Academic Career Award (GACA) was a vital resource that benefitted 222 junior faculty members. GACA availability was interrupted in 2006, followed by permanent discontinuation after the Geriatrics Workforce Education Program (GWEP) subsumed it in 2015, leaving aspiring clinician-educators with no similar alternatives...
April 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28398987/predicting-risk-and-outcomes-for-frail-older-adults-an-umbrella-review-of-frailty-screening-tools
#11
João Apóstolo, Richard Cooke, Elzbieta Bobrowicz-Campos, Silvina Santana, Maura Marcucci, Antonio Cano, Miriam Vollenbroek-Hutten, Federico Germini, Carol Holland
BACKGROUND: A scoping search identified systematic reviews on diagnostic accuracy and predictive ability of frailty measures in older adults. In most cases, research was confined to specific assessment measures related to a specific clinical model. OBJECTIVES: To summarize the best available evidence from systematic reviews in relation to reliability, validity, diagnostic accuracy and predictive ability of frailty measures in older adults. INCLUSION CRITERIA POPULATION: Older adults aged 60 years or older recruited from community, primary care, long-term residential care and hospitals...
April 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28364991/polypharmacy-and-delirium-in-critically-ill-older-adults-recognition-and-prevention
#12
REVIEW
Erik Garpestad, John W Devlin
Among older adults, polypharmacy is a sequelae of admission to the intensive care unit and is associated with increased medication-associated adverse events, drug interactions, and health care costs. Delirium is prevalent in critically ill geriatric patients and medications remain an underappreciated modifiable risk for delirium in this setting. This article reviews the literature on polypharmacy and delirium, with a focus on highlighting the relationships between polypharmacy and delirium in critically ill, older adults...
May 2017: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#13
EDITORIAL
Jonathan Afilalo
No abstract text is available yet for this article.
May 23, 2017: Circulation
https://www.readbyqxmd.com/read/28292313/relationship-between-family-caregiver-burden-and-physical-frailty-in-older-adults-without-dementia-a-systematic-review
#14
Thom Ringer, Afeez Abiola Hazzan, Arnav Agarwal, Adam Mutsaers, Alexandra Papaioannou
BACKGROUND: Physical frailty is a prevalent syndrome in older adults that increases vulnerability for a range of adverse outcomes including increased dependency and death. Caregivers of older adults experience significant physical, emotional, and financial burden, which is associated with poor physical and mental health. While it is known that care recipients' dementia is associated with burden, the literature regarding the impact of physical frailty on burden has yet to be synthesized...
March 14, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28279073/end-of-life-care-and-discussions-in-japanese-geriatric-health-service-facilities
#15
Asako Kanoh, Yoshiyuki Kizawa, Satoru Tsuneto, Shoji Yokoya
BACKGROUND: Geriatric health service facilities (GHSFs) play important roles as intermediate care facilities for elderly individuals temporarily when they need rehabilitation before returning home. However, the number of residents spending their end-of-life (EOL) period in such facilities is increasing. To improve the quality of EOL care, end-of-life discussions (EOLDs) are recommended by some guidelines and studies. AIM: This study aimed to clarify the current practice of EOL care and EOLDs in GHSFs in Japan...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28276179/effect-of-caregiving-relationship-and-formal-long-term-care-service-use-on-caregiver-well-being
#16
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/28243074/delirium-in-405-articles-of-medical-non-surgical-or-icu-inpatients-unproven-speed-of-onset-and-recovery
#17
Paul Jay Regal
PURPOSE: There is agreement in the medical literature that delirium is of sudden or rapid onset. Although the speed of recovery cannot be used for initial diagnosis, recovery speed provides a test of diagnostic criteria. The aim of this study was to determine whether articles on delirium among medical inpatients proved sudden onset and rapid recovery. METHODS: The literature was searched for studies with at least 50 patients on medical or geriatric wards. Excluded were postoperative, critical care, and nursing home studies...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28231631/commentary-response-frailty-not-just-about-old-people-reply-to-smith-gd-kydd-a-2017-getting-care-of-older-people-right-the-need-for-appropriate-frailty-assessment
#18
Sunita R Jha, Julee Mcdonagh, Caleb Ferguson, Peter S Macdonald, Phillip J Newton
As highlighted in a recent editorial, the ageing population and burden of frailty amongst those aged 60 years and older represents an impending challenge for individuals and health care systems globally (Smith & Kydd 2017). As frailty is largely considered a geriatric syndrome, research has primarily occurred within elderly community dwelling populations (Fried et al. 2001). However, it is important to highlight that not all older people are frail; and conversely not all younger people are non-frail. With frailty research expanding its scope beyond geriatrics over the last 2 decades, our understanding of this syndrome and its complexities has progressed...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28196637/an-outbreak-of-acute-gii-17-norovirus-gastroenteritis-in-a-long-term-care-facility-in-china-the-role-of-nursing-assistants
#19
Chang Cui, Lifeng Pan, Yuanping Wang, Caoyi Xue, Weiping Zhu, Linying Zhu, Chuchu Ye, Xianghua Lu, Haihong Song, Yifei Fu, Qiao Sun
More than 30 residents and nursing assistants in a geriatric nursing hospital developed acute gastroenteritis from December 7th to December 18th, 2014 in Shanghai, China. An immediate epidemiological investigation was conducted to identify the etiological agent of the outbreak, mode of transmission and the risk factors. Cases were investigated according to an epidemiological questionnaire. Samples from cases, highly transmissible environmental surfaces and drinking water were collected for pathogens detection...
February 9, 2017: Journal of Infection and Public Health
https://www.readbyqxmd.com/read/28183274/disability-in-long-term-care-residents-explained-by-prevalent-geriatric-syndromes-not-long-term-care-home-characteristics-a-cross-sectional-study
#20
Natasha E Lane, Walter P Wodchis, Cynthia M Boyd, Thérèse A Stukel
BACKGROUND: Self-care disability is dependence on others to conduct activities of daily living, such as bathing, eating and dressing. Among long-term care residents, self-care disability lowers quality of life and increases health care costs. Understanding the correlates of self-care disability in this population is critical to guide clinical care and ongoing research in Geriatrics. This study examines which resident geriatric syndromes and chronic conditions are associated with residents' self-care disability and whether these relationships vary across strata of age, sex and cognitive status...
February 10, 2017: BMC Geriatrics
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