[Feedback from a COVID-19 acute geriatric unit]. / Retour d'expérience d'une unité de gériatrie aiguë Covid-19.

Following the outbreak of coronavirus disease, many experience feedbacks have been set up, at the level of departments, hospitals or crisis units. In a geriatric ward, this helped to understand what had happened to each of the caregiver and to the community. In the event of a new wave, this will allow them to anticipate. This period strengthened the sense of belonging and the interest in the well-being of the care receiver.

[Delirium in a nursing home: a survey of general practitioners]. / Le syndrome confusionnel en Ehpad : enquête auprès de médecins généralistes.

Delirium is all the more frequent and serious when it occurs in a nursing home. A study was carried out to assess the current practices of general practitioners in the management of delirium in a nursing home in order to identify the issues involved and to suggest areas for improvement. The doctors identified three main difficulties: the management of behavioural disorders, the conditions of practice of a private practitioner in a healthcare institution and the relations with the different caregivers of the nursing home.

[Patient consent at the core of care]. / Le consentement du patient au cœur du soin.

Respecting a patient's decision is an obligation even in the case of cognitive disorders. Obtaining their consent for treatment requires attentive listening, adapted communication and reassurance techniques. The aim is to establish a relationship of trust and to create a calm and reassuring atmosphere. Caregivers are often placed at the heart of a complex situation and must therefore choose the best strategy.

[Transfusions in geriatrics]. / La transfusion en gériatrie.

Elderly people are Darticularlv Drone to anaemia and the need for transfusions. However, in response to the known adverse effects of red blood cell transfusions, particularly in the context of chronic anaemia, new recommendations have been issued. it is always necessary to consider this procedure on a case-by-case basis, analysing the risk-benefit ratio.

[A geriatrics unit with a 24 hour visiting policy]. / Une unité de gériatrie ouverte aux familles sans limitation d'horaires.

As hospitals' visiting times are extended, patients' families and friends are granted an ever more important place. The nursing team of an acute geriatrics unit open 24/7 examined the place and the role of patients' families and friends and their involvement in care.

[Anticipating the end of life]. / Anticiper la fin de vie.

For patients at the end of life, caregivers must sometimes make choices between prolonging life and quality of life. There are several tools to assist in the decision-making process and the implementation, notably with regard to the limiting of active treatment. The issues to consider include limiting or stopping treatment, Leonetti's law with advance directives and the fight against unreasonable obstinacy and, more recently, the "mandate for future protection". The patient must always remain the focus and be allowed to express their wishes, if they want to, directly or with the help of a third party.

[The importance of geriatrics-intensive care collaboration]. / L'importance de i'association gériatres-réanimateurs.

As is the case with all medical and surgical departments, the proportion of elderly patients in intensive care departments is gradually increasing.At Ambroise Pare hospital, in Boulogne-Billancourt, a natural collaboration has been set up between intensive care staff and geriatricians to adapt the care provided and to limit situations of unreasonable therapeutic obstinacy, notably thanks to a standardised gathering of information.

[Legal framework of the health care surrogate: the patients' point of view]. / Le point de vue des patients sur la personne de confiance.

A study carried out in two hospitals in the Paris region shows that the patients surveyed find the health care surrogate system interesting but also that there is widespread lack of awareness of the subject. The system appears to correspond to patients' expectations with the majority of patients nominating a family member.

[The health care surrogate in general medicine]. / La personne de confiance en médecine générale.

The theme of the surrogate is not established in the practice of general practitioners yet. Their long-term relation with patients places them in a favorable position to approach this topic. The surrogate could improve the quality of patient's care. Some factors limiting the surrogate's designation are indicators of the current deficiencies of the surrogate's device.

[Health care surrogate and Alzheimer's disease]. / Personne de confiance et maladie d'Alzheimer.

Many healthcare professionals prejudge the capacity of a patient suffering from Alzheimer's disease to designate a health care surrogate. Consequently they deprive themselves of a person with whom they can discuss the patient's care while also depriving the patient of support and assistance.While the task of the health care surrogate is made more difficult as a result of cognitive disorders, their role can only be beneficial in a balanced relationship.

[Implementation of a procedure for nominating a health care surrogate]. / Mise en oeuvre d'une procédure de désignation d'une personne de confiance.

A procedure for the systematic nomination of a health care surrogate was put in place following a multi-disciplinary approach within an acute care geriatric unit at Ambroise-Paré hospital in Boulogne-Billancourt. Its originality lies in the way the whole team, on the initiative of a doctor, prepared the procedure, implemented it and assessed it. A review.

[The 'person of trust' provision]. / Le dispositif de la personne de confiance.

During any stay in hospital, the patient must be asked to name a person of trust. This person can accompany the patient during medical consultations and act as their voice if they are no longer capable of speaking, although they are not able to give consent on their behalf.

[Should caregivers be concerned with the nutritional state of elderly patients?]. / Faut-il s'intéresser au statut nutritionnel des patients âgés?

A geriatric syndrome in its own right, malnutrition must be systematically looked for whenever an elderly patient is being treated. A marker of vulnerability, once identified it requires repeated assessment and adapted treatment. Undernutrition is often the consequence of various aetiologies justifying a full assessment and an assertive, multi-professional treatment.

Manifesto for the rights of older people.

The French Society of Geriatrics and Gerontology (SFGG) stands against ageism and strives to combat it in all its forms. The SFGG has warned about the persistence of age discrimination and the emergence of new forms of ageism alongside traditional stereotypes. The SFGG took a position on the occasion of the 70th anniversary of the Universal Declaration of Human Rights in December 2018. In September 2020, the SFGG again raised the alarm, on the 20th anniversary of the inclusion of the Rights of the Elderly in the European Charter. It has organised a wide-reaching communication campaign against ageism, involving learned societies of geriatrics and gerontology as well as all the major international institutions working to defend the rights of older adults.

[Statement for the rights of the elderly]. / Manifeste pour le droit des personnes âgées.

The SFGG (French Society of geriatrics and gerontology) stands up against ageism and fights it in all its forms of expression. The SFGG warns about the persistence of age discrimination and the emergence of new forms of ageism alongside traditional stereotypes. The SFGG has taken a position on the occasion of the 70th anniversary of the Universal Declaration of Human Rights in December 2018. In September 2020, the SFGG is again raising the alarm on the 20th anniversary of the inclusion of the Rights of the Elderly in the European Charter. It is organising a wide communication campaign against ageism, involving all the learned societies of geriatrics and gerontology as well as all the major international institutions that defend the rights of older adults.

Impaired mobility, ASA status and administration of tramadol are risk factors for postoperative delirium in patients aged 75 years or more after major abdominal surgery.

OBJECTIVE: The aim of this prospective study was to determine incidence, duration, and risk factors for postoperative delirium (PD) in elderly patients undergoing major abdominal surgery. SUMMARY BACKGROUND DATA: The incidence and risk factors of PD after major abdominal surgery in elderly patients are not well documented. METHODS: From May 2006 to May 2008, 118 patients aged 75 years or more without severe preoperative cognitive dysfunction (mini mental state examination score >10/30) and undergoing major elective abdominal surgery were included. The preoperative geriatric assessment battery consisted of 4 tests evaluating physical (instrumental activities of daily living and timed get up and go test score) and cognitive function (mini mental state examination score), and detecting the presence of an underlying depression (Short-GDS). After the operation, geriatric patients were assessed for PD by the Confusion Assessment Method. Univariate and multivariate analyses were used to determine risk factors for PD. RESULTS: Overall, PD occurred in 28 patients (24%). Multivariate analysis showed that an American Society of Anesthesiologists status of 3-4 (P = 0.02), impaired mobility (timed get up and go test score >20 seconds) (P = 0.009) and postoperative tramadol administration (P = 0.0009) were risk factors for PD. The mortality rate was 14% in 28 patients with PD and 3.3% in 90 patients without PD (P = 0.051). The morbidity rate was 35.5% in 28 patients with PD and 32% in 90 patients without PD (NS). The mean hospital stay was 19 +/- 11 days for patients with PD and 14 +/- 8 for patients without PD (P = 0.01). Fifteen of 24 (62.5%) surviving patients with PD and 28 of 87 (32%) surviving patients without PD were discharged to geriatric rehabilitation unit (P = 0.007). CONCLUSIONS: PD is a frequent and severe postoperative event in elderly patients after major abdominal surgery. A perioperative geriatric assessment should be recommended to patients with an American Society of Anesthesiologists status of 3-4 and preoperative impaired mobility to facilitate the management of PD. In these patients, the postoperative administration of tramadol should be avoided.