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1.
Emerg Med Clin North Am ; 39(2): 243-255, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33863457

RESUMEN

Geriatric emergency medicine has emerged as a subspecialty of emergency medicine over the past 25 years. This emergence has seen the development of increases in training opportunities, care delivery strategies, collaborative best practice guidelines, and formal geriatric emergency department accreditation. This multidisciplinary field remains ripe for continued development in the coming decades as the aging US population parallels a call from patients, health care providers, and health systems to improve the delivery of high-value care. This article educates emergency medicine practitioners and highlights high-value care practice trends to inform and prioritize decision-making for this unique patient population.


Asunto(s)
Medicina de Emergencia/tendencias , Geriatría/tendencias , Anciano , Educación de Postgrado en Medicina , Servicio de Urgencia en Hospital , Evaluación Geriátrica , Enfermería Geriátrica/educación , Humanos , Dinámica Poblacional , Guías de Práctica Clínica como Asunto
2.
Emerg Med Clin North Am ; 39(2): 429-442, 2021 May.
Artículo en Inglés | MEDLINE | ID: mdl-33863470

RESUMEN

Each emergency department (ED) visit represents a crucial transition of care for older adults. Systems, provider, and patient factors are barriers to safe transitions and can contribute to morbidity and mortality in older adults. Safe transitions from ED to inpatient, ED to skilled nursing facility, or ED back to the community require a holistic approach, such as the 4-Ms model-what matters (patient goals of care), medication, mentation, and mobility-along with safety and social support. Clear written and verbal communication with patients, caregivers, and other members of the interdisciplinary team is paramount in ensuring successful care transitions.


Asunto(s)
Continuidad de la Atención al Paciente , Servicio de Urgencia en Hospital , Transferencia de Pacientes/organización & administración , Anciano , Evaluación Geriátrica , Geriatría , Humanos , Seguridad del Paciente
3.
Soins Gerontol ; 26(148): 24-25, 2021.
Artículo en Francés | MEDLINE | ID: mdl-33894910

RESUMEN

The Alzheimer's plans have led to significant progress in the care management of elderly people suffering from Alzheimer's disease or other forms of dementia, but the medical and social network remains fragmented in geriatrics. We have proposed to caregivers a monthly videoconference combining expert presentations and discussion of clinical cases. Several health professions were represented. The main positive point was the time saved. The videoconferencing improved multidisciplinary exchanges, especially for patients with complex problems and their families.


Asunto(s)
Enfermedad de Alzheimer , Geriatría , Anciano , Cuidadores , Psiquiatría Geriátrica , Humanos , Comunicación por Videocoferencia
4.
Sr Care Pharm ; 36(4): 176-186, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-33766190

RESUMEN

Five new drugs marketed within the last year that are used for medical problems often experienced by older people have been selected for consideration in this review. The uses and most important properties of these agents are discussed, and a rating for each new drug is determined using the New Drug Comparison Rating (NDCR) system developed by the author (DAH). Advantages, disadvantages, and other important information regarding each new drug are identified and used as the basis for determining the rating. The drugs considered include new agents indicated for the treatment of patients with hypercholesterolemia, Parkinson's disease, insomnia, schizophrenia, and age-related macular degeneration.


Asunto(s)
Aprobación de Drogas , Geriatría , Preparaciones Farmacéuticas , Anciano , Anciano de 80 o más Años , Humanos
5.
J Prim Care Community Health ; 12: 21501327211000235, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33729044

RESUMEN

BACKGROUND: To characterize the experience of converting a geriatrics clinic to telehealth visits in early stages of a pandemic. DESIGN: An organizational case study with mixed methods evaluation from the first 8 weeks of converting a geriatrics clinic from in-person visits to video and telephone visits. SETTING: Veteran's Health Administration in Northern California Participants Community-dwelling older Veterans receiving care at VA Palo Alto Geriatrics clinic. Veterans had a mean age of 85.7 (SD = 6.8) and 72.1% had cognitive impairment. INTERVENTION: Veterans with face-to-face appointments were converted to video or telephone visits to mitigate exposure to community spread of COVID-19. MEASUREMENTS: Thirty-two patient evaluations and 80 clinician feedback evaluations were completed. This provided information on satisfaction, care access during pandemic, and travel and time savings. RESULTS: Of the 62 scheduled appointments, 43 virtual visits (69.4%) were conducted. Twenty-six (60.5%) visits were conducted via video, 17 (39.5%) by telephone. Virtual visits saved patients an average of 118.6 minutes each. Patients and providers had similar, positive perceptions about telehealth to in-person visit comparison, limiting exposure, and visit satisfaction. After the telehealth appointment, patients indicated greater comfort with using virtual visits in the future. Thirty-one evaluations included comments for qualitative analysis. We identified 3 main themes of technology set-up and usability, satisfaction with visit, and clinical assessment and communication. CONCLUSION: During a pandemic that has limited the ability to safely conduct inperson services, virtual formats offer a feasible and acceptable alternative for clinically-complex older patients. Despite potential barriers and additional effort required for telehealth visits, patients expressed willingness to utilize this format. Patients and providers reported high satisfaction, particularly with the ability to access care similar to in-person while staying safe. Investing in telehealth services during a pandemic ensures that vulnerable older patients can access care while maintaining social distancing, an important safety measure.


Asunto(s)
Instituciones de Atención Ambulatoria/organización & administración , Geriatría/organización & administración , Telemedicina/organización & administración , Servicios de Salud para Veteranos/organización & administración , Adulto , Anciano , Anciano de 80 o más Años , California/epidemiología , Demencia/terapia , Accesibilidad a los Servicios de Salud , Humanos , Persona de Mediana Edad , Estudios de Casos Organizacionales , Atención Primaria de Salud/organización & administración , Investigación Cualitativa , Teléfono , Comunicación por Videocoferencia
6.
Soins ; 66(853): 39-42, 2021 Mar.
Artículo en Francés | MEDLINE | ID: mdl-33775302

RESUMEN

The first challenge, after graduating as an advanced practice nurse is to establish a new model of care in one's place of practice. The feedback from the creation of an advanced practice nurse position in oncology in Amiens-Picardie university hospital, using a population-based approach, illustrates the roles and skills required in this new health profession.


Asunto(s)
Enfermería de Práctica Avanzada/organización & administración , Geriatría , Oncología Médica , Neoplasias , Anciano , Francia , Geriatría/organización & administración , Hospitales Universitarios , Humanos , Oncología Médica/organización & administración , Neoplasias/enfermería
8.
Artículo en Inglés | MEDLINE | ID: mdl-33670270

RESUMEN

Introduction: Globally, the COVID-19 pandemic has affected older people disproportionately. Prior to the pandemic, some studies reported that telehealth was an efficient and effective form of health care delivery, particularly for older people. There has been increased use of telehealth and publication of new literature on this topic during the pandemic, so we conducted a scoping review and evidence synthesis for telehealth use in geriatric care to summarize learning from these new data. Methods: We searched PubMed, Embase, and the World Health Organization's COVID-19 global research database for articles published between 1 January and 20 August 2020. We included 79 articles that met our inclusion criteria. The information collected has been synthesized and presented as descriptive statistics. Strengths, weaknesses, opportunities, and threats (SWOT) have also been discussed. Results: The articles included in our review provide some evidence of effective provision of preventive, curative, and rehabilitative telehealth services for older people, but they highlight a greater focus on curative services and are mostly concentrated in high-income countries. We identified convenience and affordability as the strengths of telehealth use in geriatric care. Weaknesses identified include the inability of telehealth to cater to the needs of older people with specific physical and cognitive limitations. While the threats of increasing inequity and the lack of standardization in the provision of age-friendly telehealth services remain, we identified opportunities for technologic advancements driven by simplicity and user-friendliness for older people. Conclusion: Telehealth offers futuristic promise for the provision of essential health care services for older people worldwide. However, the extent of these services via telehealth appears to be currently limited in low and low-middle income countries. Optimizing telehealth services that can be accessed by older people requires greater government investments and active engagement by broader participation of older people, their caregivers, physicians and other health care providers, technology experts, and health managers.


Asunto(s)
Geriatría/tendencias , Telemedicina/tendencias , Anciano , Anciano de 80 o más Años , Humanos , Pandemias
9.
Nurs Educ Perspect ; 42(3): 148-151, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33660681

RESUMEN

AIM: This study examined how intentional first encounters as a nursing student, as well as prior relationships with older adults, influenced baccalaureate prelicensure nursing students' attitudes toward this population. BACKGROUND: There is a growing demand for knowledgeable and skilled nurses to provide person-centered care to an aging population. An ongoing challenge is lack of interest in practicing within gerontological settings following graduation. METHOD: A cross-sectional, correlational, comparison research design was used. Ninety-nine nursing students in five groups were recruited from six baccalaureate prelicensure nursing schools. RESULTS: A one-way analysis of variance revealed a significant difference among groups, F(4, 94) = 4.873, p = .001. Students completing clinical in half-semester acute care and long-term care (M = 64.03, SD = 16.9) had better attitudes than students in other clinical experiences. CONCLUSION: Addressing the development of positive attitudes in nursing students remains imperative to promote person-centered care to the aging population.


Asunto(s)
Bachillerato en Enfermería , Enfermería Geriátrica , Geriatría , Estudiantes de Enfermería , Anciano , Actitud del Personal de Salud , Estudios Transversales , Humanos , Facultades de Enfermería , Encuestas y Cuestionarios
10.
Washington, D.C.; OPAS; 2021-03-09. (OPAS-W/FPL/IM/21-0007).
en Portugués | PAHO-IRIS | ID: phr-53357

RESUMEN

O Programa de Atenção Integrada para a Pessoa Idosa (ICOPE) foi desenvolvido pela Organização Mundial da Saúde (OMS) para atender às necessidades e demandas de saúde das populações idosas em todo o mundo. Em 2050, a proporção da população global com 60 anos ou mais quase dobrará. Nas Américas, a expectativa de vida aumentou 21,6 anos nas últimas seis décadas. No entanto, viver mais frequentemente significa enfrentar problemas de saúde acumulados durante a velhice. A transição demográfica afetará quase todos os aspectos da sociedade e criará novos e complexos desafios para os sistemas de saúde e assistência social. Portanto, é necessária uma abordagem transformadora na maneira como os sistemas de saúde e os serviços dentro deles são estruturados - para garantir cuidados de alta qualidade que sejam integrados, acessíveis e com foco nas necessidades e direitos das pessoas idosas. A atenção integrada, especialmente para as pessoas idosas e com condições crônicas de saúde, é amplamente aceita como um mecanismo para melhorar os resultados de saúde e a eficiência do sistema. O Manual ICOPE fornece orientações detalhadas para ajudar os profissionais de saúde e cuidadores da comunidade a colocar em prática a atenção integrada para a pessoa idosa, através do desenvolvimento de um plano de cuidados. Dessa forma, o manual auxilia na definição de metas centradas na pessoa e na integração de abordagens nos diferentes níveis de atenção. O plano de cuidados pode incluir várias intervenções para gerenciar declínios na capacidade intrínseca, fornecer assistência e apoio social, desenvolver capacidade para o automanejo e apoiar os cuidadores. A brochura ICOPE apresenta os destaques da abordagem ICOPE para facilitar a sua divulgação e favorecer uma ampla apresentação do método.


Asunto(s)
Anciano , Envejecimiento , Disciplinas de las Ciencias Biológicas , Dinámica Poblacional , Envejecimiento Saludable , Salud del Anciano , Personal de Salud , Servicios de Salud para Ancianos , Fenómenos Fisiológicos Nutricionales del Anciano , Cognición , Disfunción Cognitiva , Orientación , Psicoterapia , Remediación Cognitiva , Terapia Cognitivo-Conductual , Pruebas de Estado Mental y Demencia , Geriatría , Incontinencia Urinaria , Sensación , Suplementos Dietéticos , Accidentes por Caídas , Prevención y Mitigación , Prevención de Accidentes
11.
Soins ; 66(853): 35-38, 2021 Mar.
Artículo en Francés | MEDLINE | ID: mdl-33775301

RESUMEN

Le Mans general hospital has created an advanced practice nurse position in memory clinics in geriatrics. The activity began in September 2019. During the first year, 189 consultations with the nurse were carried out, despite the difficult health context. Most of the activity has focused on consultations. However, the nurse's other skills have also been deployed. An analysis of the activity enables the areas to improve to be identified in order to continue creating advanced practice nursing positions within the hospital and across the country.


Asunto(s)
Enfermería de Práctica Avanzada , Trastornos de la Memoria , Anciano , Francia , Geriatría , Hospitales Generales , Humanos , Trastornos de la Memoria/enfermería , Derivación y Consulta
13.
Epidemiol Psychiatr Sci ; 30: e10, 2021 Feb 02.
Artículo en Inglés | MEDLINE | ID: mdl-33526166

RESUMEN

AIMS: Late-life depression has substantial impacts on individuals, families and society. Knowledge gaps remain in estimating the economic impacts associated with late-life depression by symptom severity, which has implications for resource prioritisation and research design (such as in modelling). This study examined the incremental health and social care expenditure of depressive symptoms by severity. METHODS: We analysed data collected from 2707 older adults aged 60 years and over in Hong Kong. The Patient Health Questionnaire-9 (PHQ-9) and the Client Service Receipt Inventory were used, respectively, to measure depressive symptoms and service utilisation as a basis for calculating care expenditure. Two-part models were used to estimate the incremental expenditure associated with symptom severity over 1 year. RESULTS: The average PHQ-9 score was 6.3 (standard deviation, s.d. = 4.0). The percentages of respondents with mild, moderate and moderately severe symptoms and non-depressed were 51.8%, 13.5%, 3.7% and 31.0%, respectively. Overall, the moderately severe group generated the largest average incremental expenditure (US$5886; 95% CI 1126-10 647 or a 272% increase), followed by the mild group (US$3849; 95% CI 2520-5177 or a 176% increase) and the moderate group (US$1843; 95% CI 854-2831, or 85% increase). Non-psychiatric healthcare was the main cost component in a mild symptom group, after controlling for other chronic conditions and covariates. The average incremental association between PHQ-9 score and overall care expenditure peaked at PHQ-9 score of 4 (US$691; 95% CI 444-939), then gradually fell to negative between scores of 12 (US$ - 35; 95% CI - 530 to 460) and 19 (US$ -171; 95% CI - 417 to 76) and soared to positive and rebounded at the score of 23 (US$601; 95% CI -1652 to 2854). CONCLUSIONS: The association between depressive symptoms and care expenditure is stronger among older adults with mild and moderately severe symptoms. Older adults with the same symptom severity have different care utilisation and expenditure patterns. Non-psychiatric healthcare is the major cost element. These findings inform ways to optimise policy efforts to improve the financial sustainability of health and long-term care systems, including the involvement of primary care physicians and other geriatric healthcare providers in preventing and treating depression among older adults and related budgeting and accounting issues across services.


Asunto(s)
Servicios de Salud Comunitaria/estadística & datos numéricos , Depresión/terapia , Gastos en Salud/estadística & datos numéricos , Calidad de Vida/psicología , Anciano , Anciano de 80 o más Años , Servicios de Salud Comunitaria/economía , Análisis Costo-Beneficio , Estudios Transversales , Trastorno Depresivo Mayor/terapia , Femenino , Geriatría , Investigación sobre Servicios de Salud , Hong Kong , Humanos , Vida Independiente , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , Apoyo Social
14.
J Prev Med Public Health ; 54(1): 63-72, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33618501

RESUMEN

OBJECTIVES: Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults. METHODS: This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry. RESULTS: In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS. CONCLUSIONS: Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.


Asunto(s)
Depresión/complicaciones , Fuerza de la Mano/fisiología , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/fisiopatología , Depresión/psicología , Femenino , Geriatría/instrumentación , Geriatría/métodos , Geriatría/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Cuestionario de Salud del Paciente , República de Corea
15.
Acta Med Hist Adriat ; 18(2): 273-290, 2021 12.
Artículo en Inglés, Croata | MEDLINE | ID: mdl-33535763

RESUMEN

Doctor Apolinary Tarnawski (1851-1943) was undoubtedly the precursor of modern natural medicine, preventive medicine, and geriatric physiotherapy in Poland. Based on the experience gained from foreign scientific travel, own knowledge and experience, he developed an original method that he successfully used in his own clinic in Kosów. His assumptions proved to be timeless, and despite the passage of many years have not lost their relevance.


Asunto(s)
Geriatría/historia , Modalidades de Fisioterapia/historia , Médicos/historia , Historia del Siglo XIX , Historia del Siglo XX , Polonia
16.
Horm Mol Biol Clin Investig ; 42(1): 87-98, 2021 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-33544506

RESUMEN

The COVID-19 pandemic has not only led to a worldwide socio-economic depression, but has also had the highest health impact on the geriatric population. Elderly population, due to various reasons such as low immunity, pre-existing co-morbidities such as hypertension, cardiovascular diseases or diabetes, are obviously predisposed to develop severe infections and exhibit a high mortality rate. This is because of many reasons which include the atypical presentation in the geriatric population which might have led to diagnostic delay. As per the WHO guidelines to perform RT-PCR only on the symptomatic individuals, a very small portion of individuals were tested, leaving a fraction of population undiagnosed. Therefore, there remained a chance that many asymptomatic individuals such caregivers, healthcare professionals, family members were undiagnosed and might have carried this virus to the geriatric patients. Also, many countries were not prepared to handle the burden on their healthcare system which included sudden increased demand of ICU beds, mechanical ventilation etc. As a result, they had to make decision on who to be admitted. Atypical presentation in geriatric population may include afebrile or low-grade fever, absence of cough, malaise, muscle pains, dyspnoea etc. Geriatric population shows a more severe type of pneumonia, significantly higher number of neutrophils and C-reactive protein, less lymphocytes and a higher proportion of multiple lobe involvement. Extreme social suppression during COVID-19 pandemic has increased the risk of mental and physical adverse effects that has made older adults more vulnerable to depression and anxiety.


Asunto(s)
Envejecimiento/fisiología , /patología , Factores de Edad , Anciano , Anciano de 80 o más Años , Envejecimiento/inmunología , /inmunología , Diagnóstico Tardío , Geriatría , Humanos , Persona de Mediana Edad , Pandemias , Pronóstico , Índice de Severidad de la Enfermedad
17.
Mil Med Res ; 8(1): 14, 2021 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-33593441

RESUMEN

The potential association between medical resources and the proportion of oldest-old (90 years of age and above) in the Chinese population was examined, and we found that the higher proportion of oldest-old was associated with the higher number of beds in hospitals and health centers.


Asunto(s)
Geriatría/métodos , Recursos en Salud/normas , Asignación de Recursos/provisión & distribución , Anciano de 80 o más Años , China/epidemiología , Geriatría/normas , Geriatría/estadística & datos numéricos , Recursos en Salud/estadística & datos numéricos , Humanos , Factores de Riesgo
19.
J Frailty Aging ; 10(2): 86-93, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33575696

RESUMEN

Aging is the most important risk factor for the onset of several chronic diseases and functional decline. Understanding the interplays between biological aging and the biology of diseases and functional loss as well as integrating a function-centered approach to the care pathway of older adults are crucial steps towards the elaboration of preventive strategies (both pharmacological and non-pharmacological) against the onset and severity of burdensome chronic conditions during aging. In order to tackle these two crucial challenges, ie, how both the manipulation of biological aging and the implementation of a function-centered care pathway (the Integrated Care for Older People (ICOPE) model of the World Health Organization) may contribute to the trajectories of healthy aging, a new initiative on Gerosciences was built: the INSPIRE research program. The present article describes the scientific background on which the foundations of the INSPIRE program have been constructed and provides the general lines of this initiative that involves researchers from basic and translational science, clinical gerontology, geriatrics and primary care, and public health.


Asunto(s)
Investigación Biomédica , Geriatría , Envejecimiento Saludable , Anciano , Animales , Prestación de Atención de Salud , Humanos , Modelos Animales
20.
J Frailty Aging ; 10(2): 103-109, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33575698

RESUMEN

INTRODUCTION: Limiting the number of dependent older people in coming years will be a major economic and human challenge. In response, the World Health Organization (WHO) has developed the «Integrated Care for Older People (ICOPE)¼ approach. The aim of the ICOPE program is to enable as many people as possible to age in good health. To reach this objective, the WHO proposes to follow the trajectory of an individual's intrinsic capacity, which is the composite of all their physical and mental capacities and comprised of multiple domains including mobility, cognition, vitality / nutrition, psychological state, vision, hearing. OBJECTIVE: The main objective of the INSPIRE ICOPE-CARE program is to implement, in clinical practice at a large scale, the WHO ICOPE program in the Occitania region, in France, to promote healthy aging and maintain the autonomy of seniors using digital medicine. METHOD: The target population is independent seniors aged 60 years and over. To follow this population, the 6 domains of intrinsic capacity are systematically monitored with pre-established tools proposed by WHO especially STEP 1 which has been adapted in digital form to make remote and large-scale monitoring possible. Two tools were developed: the ICOPE MONITOR, an application, and the BOTFRAIL, a conversational robot. Both are connected to the Gerontopole frailty database. STEP 1 is performed every 4-6 months by professionals or seniors themselves. If a deterioration in one or more domains of intrinsic capacity is identified, an alert is generated by an algorithm which allows health professionals to quickly intervene. The operational implementation of the INSPIRE ICOPE-CARE program in Occitania is done by the network of Territorial Teams of Aging and Prevention of Dependency (ETVPD) which have more than 2,200 members composed of professionals in the medical, medico-social and social sectors. Targeted actions have started to deploy the use of STEP 1 by healthcare professionals (physicians, nurses, pharmacists,…) or different institutions like French National old age insurance fund (CNAV), complementary pension funds (CEDIP), Departmental Council of Haute Garonne, etc. Perspective: The INSPIRE ICOPE-CARE program draws significantly on numeric tools, e-health and digital medicine to facilitate communication and coordination between professionals and seniors. It seeks to screen and monitor 200,000 older people in Occitania region within 3 to 5 years and promote preventive actions. The French Presidential Plan Grand Age aims to largely implement the WHO ICOPE program in France following the experience of the INSPIRE ICOPE-CARE program in Occitania.


Asunto(s)
Conducta Cooperativa , Prestación Integrada de Atención de Salud , Geriatría , Desarrollo de Programa , Organización Mundial de la Salud , Anciano , Anciano de 80 o más Años , Prestación Integrada de Atención de Salud/organización & administración , Francia , Geriatría/organización & administración , Humanos , Persona de Mediana Edad , Organización Mundial de la Salud/organización & administración
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