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Complex geriatric care

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https://www.readbyqxmd.com/read/29115922/the-prevalence-of-dementia-in-a-portuguese-community-sample-a-10-66-dementia-research-group-study
#1
Manuel Gonçalves-Pereira, Ana Cardoso, Ana Verdelho, Joaquim Alves da Silva, Manuel Caldas de Almeida, Alexandra Fernandes, Cátia Raminhos, Cleusa P Ferri, A Matthew Prina, Martin Prince, Miguel Xavier
BACKGROUND: Dementia imposes a high burden of disease worldwide. Recent epidemiological studies in European community samples are scarce. In Portugal, community prevalence data is very limited. The 10/66 Dementia Research Group (DRG) population-based research programmes are focused in low and middle income countries, where the assessments proved to be culture and education fair. We applied the 10/66 DRG prevalence survey methodology in Portugal, where levels of illiteracy in older populations are still high...
November 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29090032/the-psychological-abuse-of-the-elderly-a-silent-factor-of-cardiac-decompensation
#2
Adina Carmen Ilie, Anca Iuliana Pîslaru, Ioana Dana Alexa, Adriana Pancu, Ovidiu Gavrilovici, Aliona Dronic
Abuse of the elderly is a major issue debated worldwide. The most commonly identified form of abuse is the physical abuse. It is also the most frequently studied in the medical literature. However, at least six types of elder abuse are identified, and physical abuse is found in a small proportion of the cases. The consequences of abuse are frequent and, by prolonging hospitalizations, they will be associated with high costs of medical services, and patient's lack of self-confidence which, in time, may lead to social isolation, somatization, anxiety, depression, and suicide attempts...
June 2017: Mædica
https://www.readbyqxmd.com/read/29083443/health-promotion-and-preventive-care-intervention-for-older-community-dwelling-people-long-term-effects-of-a-randomised-controlled-trial-rct-within-the-lucas-cohort
#3
L Neumann, U Dapp, W von Renteln-Kruse, C E Minder
OBJECTIVES: An RCT of a health promotion and preventive care intervention was done in 2001-2002. Here, long-term analyses based on 12 years of follow-up of survival and of change in functional competence between intervention and control group are presented. Positive 1-year results (significantly higher use of preventive services and better health behaviour) were presented earlier. DESIGN: Parallel group randomised controlled trial (RCT) with 878 participants in the intervention and 1,702 participants in the control group...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/29077231/disseminating-and-sustaining-emergency-department-innovations-for-older-adults-good-ideas-deserve-better-policies
#4
Alexander X Lo, Kevin Biese
Older adults often visit the emergency department (ED) with chief complaints that understate or detract from their true complex health care needs. These needs are frequently missed because addressing them requires a time-consuming effort that is antithetical to the (necessarily) rapid, complaint-specific protocols of the ED. Key ED performance indices (e.g., length of stay; through-put) also create a disincentive against undertaking comprehensive geriatric assessments when not clearly germane to the chief complaint...
October 27, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29052288/implementation-of-a-gerontology-nurse-specialist-role-in-primary-health-care-health-professional-and-older-adult-perspectives
#5
A I I King, M L Boyd, L Dagley, D L Raphael
AIMS AND OBJECTIVES: To explore an innovative primary healthcare gerontology nurse specialist role from the perspectives of older people and health professionals. BACKGROUND: Primary care is struggling to meet the needs and demands of complex older people. New models which incorporate holistic assessment and care coordination are necessary. DESIGN: A qualitative descriptive general inductive design was used. METHODS: Older people at risk of health and functional decline were identified and received a comprehensive gerontology assessment and care coordination...
October 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29036823/prevalence-and-correlates-of-behavioral-disorders-in-old-age-subjects-with-cognitive-impairment-results-from-the-regal-project
#6
Virginia Boccardi, Manuela Conestabile Della Staffa, Marta Baroni, Sara Ercolani, Michele Francesco Croce, Carmelinda Ruggiero, Patrizia Mecocci
BACKGROUND: Presence of behavioral and psychological symptoms of dementia (BPSD) is very common in subjects with cognitive impairment, representing an important determinant of disease progression, institutionalization, and worse prognosis. Knowledge of the prevalence and correlates of BPSD in community-living old subjects with cognitive impairment is limited so far, but it is essential for establishing specifically tailored care and cure in such a vulnerable population. OBJECTIVE: With this study, we aimed at investigating, in a large sample of old age subjects with cognitive impairment, BPSD prevalence and correlates including the main demographic, clinical, and socio-environmental characteristics...
October 8, 2017: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29018069/using-comprehensive-geriatric-assessment-for-quality-improvements-in-healthcare-of-older-people-in-uk-care-homes-protocol-for-realist-review-within-proactive-healthcare-of-older-people-in-care-homes-peach-study
#7
Maria Zubair, Neil H Chadborn, John R F Gladman, Tom Dening, Adam L Gordon, Claire Goodman
INTRODUCTION: Care home residents are relatively high users of healthcare resources and may have complex needs. Comprehensive geriatric assessment (CGA) may benefit care home residents and improve efficiency of care delivery. This is an approach to care in which there is a thorough multidisciplinary assessment (physical and mental health, functioning and physical and social environments) and a care plan based on this assessment, usually delivered by a multidisciplinary team. The CGA process is known to improve outcomes for community-dwelling older people and those in receipt of hospital care, but less is known about its efficacy in care home residents...
October 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28975616/percutaneous-feeding-tubes-in-individuals-with-advanced-dementia-are-physicians-choosing-wisely
#8
Marzena Gieniusz, Liron Sinvani, Andrzej Kozikowski, Vidhi Patel, Christian Nouryan, Myia S Williams, Nina Kohn, Renee Pekmezaris, Gisele Wolf-Klein
OBJECTIVES: To evaluate physician knowledge and perceptions about the American Board of Internal Medicine/American Geriatrics Society (ABIM/AGS) Choosing Wisely recommendations regarding percutaneous endoscopic gastrostomy (PEG) in individuals with advanced dementia. DESIGN: Multicenter, mixed-mode, anonymous questionnaire. SETTING: Three tertiary and four community hospitals in New York. PARTICIPANTS: Internal medicine physicians (N = 168)...
October 4, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28973516/effect-of-promoting-high-quality-staff-interactions-on-fall-prevention-in-nursing-homes-a-cluster-randomized-trial
#9
RANDOMIZED CONTROLLED TRIAL
Cathleen S Colón-Emeric, Kirsten Corazzini, Eleanor S McConnell, Wei Pan, Mark Toles, Rasheeda Hall, Michael P Cary, Melissa Batchelor-Murphy, Tracey Yap, Amber L Anderson, Andrew Burd, Sathya Amarasekara, Ruth A Anderson
Importance: New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. Objective: To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Design, Setting, and Participants: Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control)...
November 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28963658/-geriatric-rehabilitation-care-doing-the-right-things-right
#10
A J B M de Vos, R van Balen, R J J Gobbens, T J E M Bakker
BACKGROUND: Geriatric rehabilitation concerns short-term integrated multidisciplinary care aimed at functional recovery and social participation for relatively frail elderly. Given the geriatric clients' complex care issues, nurses should possess sufficient and appropriate competencies in order to identify and assess the relevant symptoms and intervene effectively. Yet, nurses experience a certain apprehensiveness to perform their tasks and express difficulties in multidisciplinary communication and collaboration in a constructive manner...
September 29, 2017: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/28963282/the-potential-clinical-benefits-of-medicines-optimisation-through-comprehensive-geriatric-assessment-carried-out-by-secondary-care-geriatricians-in-a-general-practice-care-setting-in-north-staffordshire-uk-a-feasibility-study
#11
Simon Christian Lea, Keira Louise Watts, Nathan Ashley Davis, Barnabas Panayiotou, Michael John Bankart, Amit Arora, Ruth Chambers
OBJECTIVES: To evaluate the feasibility and potential clinical benefits of medicines optimisation through comprehensive geriatric assessment (CGA) of frail patients with multiple conditions, by secondary care geriatricians in a general practice care setting. METHODS: Seven general practitioner (GP) practices in one region of Stoke-on-Trent volunteered to take part. GPs selected patients (n=186) who were local permanent residents, at least 65 years old and on eight or more medications per day...
September 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/28958168/a-qualitative-study-of-healthcare-provider-perspectives-on-measuring-functional-outcomes-in-geriatric-rehabilitation
#12
Christine Glenny, Ayse Kuspinar, Gary Naglie, Paul Stolee
OBJECTIVES: To explore, from the perspective of healthcare providers, the barriers to and facilitators of using standardized outcome measures of physical function in geriatric rehabilitation settings. METHODS: In-depth semi-structured interviews with medical doctors, nurses, physiotherapists and occupational therapists were conducted from three geriatric rehabilitation hospitals in Ontario. Qualitative content analysis through an inductive approach was used to identify barriers to and facilitators of outcome measurement in geriatric rehabilitation settings...
September 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28954689/health-service-use-in-the-older-person-with-complex-health-needs
#13
Mark Bartlett, Joanna Wang, Liz Hay, Glen Pang
Objective Effective health care for older people with complex health needs requires a diverse range of healthcare professionals working together. The Building Partnerships Framework of the New South Wales Agency for Clinical Innovation seeks to promote collaboration and integration among service providers. The aim of the present study was to inform implementation and evaluation of the Framework.Methods Data from the 45 and Up Study was linked with deaths and service data from hospitalisations and the Medicare Benefits Schedule (MBS)...
September 28, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28953166/a-post-master-s-advanced-certificate-in-gerontology-for-nps
#14
Sherry A Greenberg, Allison Squires, Jennifer Adams, Lisa Altshuler, So-Young Oh, Nina L Blachman, Tara A Cortes
This article describes an innovative post-master's advanced certificate in gerontology program developed by the Hartford Institute for Geriatric Nursing at the New York University Rory Meyers College of Nursing. The program provides advanced practice registered nurses geriatric content to meet eligibility criteria for the Adult-Gerontology Primary Care NP certification exam and develops interprofessional care providers to care for complex older adults.
August 4, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28942563/polypharmacy-in-the-geriatric-oncology-population
#15
REVIEW
Lauren R Hersh, Kathryn Beldowski, Emily R Hajjar
PURPOSE OF REVIEW: This review explores the multiple definitions, epidemiology, and impact of polypharmacy in geriatric oncology patients. Risk factors and clinical implications of polypharmacy are delineated and potential clinical approaches to reduce polypharmacy are reviewed. RECENT FINDINGS: Most sources currently define polypharmacy as the administration of multiple medications that are non-essential, unnecessary, duplicative, or ineffective. Possible risk factors associated with polypharmacy in geriatric cancer patients include comorbid conditions, prescribing cascades, and hospitalization...
September 23, 2017: Current Oncology Reports
https://www.readbyqxmd.com/read/28922992/policy-maker-attitudes-to-the-ageing-of-the-hiv-cohort-in-botswana
#16
Kabo Matlho, Refelwetswe Lebelonyane, Tim Driscoll, Joel Negin
BACKGROUND: The roll out of antiretroviral therapy in Botswana, as in many countries with near universal access to treatment, has transformed HIV into a complex yet manageable chronic condition and has led to the emergence of a population aging with HIV. Although there has been some realization of this development at international level, no clear defined intervention strategy has been established in many highly affected countries. Therefore we explored attitudes of policy-makers and service providers towards HIV among older adults (50 years or older) in Botswana...
December 2017: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
https://www.readbyqxmd.com/read/28876455/the-age-friendly-health-system-imperative
#17
Terry Fulmer, Kedar S Mate, Amy Berman
The unprecedented changes happening in the American healthcare system have many on high alert as they try to anticipate legislative actions. Significant efforts to move from volume to value, along with changing incentives and alternative payment models, will affect practice and the health system budget. In tandem, growth in the population aged 65 and older is celebratory and daunting. The John A. Hartford Foundation is partnering with the Institute for Healthcare Improvement to envision an age-friendly health system of the future...
September 6, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28871795/increasing-burden-of-complex-multimorbidity-across-gradients-of-cognitive-impairment
#18
Siran M Koroukian, Nicholas K Schiltz, David F Warner, Kurt C Stange, Kathleen A Smyth
INTRODUCTION: This study evaluates the burden of multimorbidity (MM) across gradients of cognitive impairment (CI). METHODS: Using data from the 2010 Health and Retirement Study, we identified individuals with no CI, mild CI, and moderate/severe CI. In addition, we adopted an expansive definition of complex MM by accounting for the occurrence and co-occurrence of chronic conditions, functional limitations, and geriatric syndromes. RESULTS: In a sample of 18 913 participants (weighted n = 87...
January 1, 2017: American Journal of Alzheimer's Disease and Other Dementias
https://www.readbyqxmd.com/read/28866353/frail-questionnaire-screening-tool-and-short-term-outcomes-in-geriatric-fracture-patients
#19
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/28865697/-cancer-and-elderly-people-what-palliative-care
#20
REVIEW
Stéphanie Benyahia, Karima N'Fissi, Marine Sahut-D'Izarn, Tristan Cudennec
Epidemiological data relating to cancer and the ageing of the population highlight the need for oncology, geriatrics and palliative care to work more closely together. Geriatric and palliative care assessments in oncology are complex procedures and result in the modification of the oncological therapeutic choices. They have a significant impact on the methods of treatment of the patients concerned.
August 2017: Revue de L'infirmière
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