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Sample records for geriatric nursing

  1. Enhancing Geriatric Curriculum in Nursing School

    ERIC Educational Resources Information Center

    Collins, Kevin

    2013-01-01

    People are living longer. The average age of the population is increasing, and is expected to keep growing. Any person age 65 and older is now considered "geriatric." However, although growing, this population is not receiving adequate nursing care, and results in increased pain, falls, and even death. Geriatric curriculum is becoming…

  2. Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

    PubMed Central

    Peters, Claudia; Schablon, Anja; Bollongino, Kirsten; Maaß, Monika; Kaß, Dietmar; Dulon, Madeleine; Diel, Roland; Nienhaus, Albert

    2014-01-01

    Background: The increase of multidrug-resistant organisms (MDROs) causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff. Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs. Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution. Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work. PMID:25285266

  3. The Filipino Nursing Students' Dilemmas in Geriatric Care

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Cruz, Andrei Angelo R.; Cruz, Angela Laurice G.; Cruz, Robert Edward D.; Cuarto, Jose Mari Nino L.

    2009-01-01

    The continually rising percentage of the elderly population and the demand for geriatric nursing care are dramatically related. While it is true that most undergraduate programs prepare nurses for the care of geriatric patients, most receive limited academic preparation in the nursing curriculum (Williams & Mezey, 2000). This is particularly true…

  4. Improving the quality of geriatric nursing care: enduring outcomes from the geriatric nursing education consortium.

    PubMed

    Gray-Miceli, Deanna; Wilson, Laurie Dodge; Stanley, Joan; Watman, Rachael; Shire, Amy; Sofaer, Shoshanna; Mezey, Mathy

    2014-01-01

    The nation's aging demography, few nursing faculty with gerontological nursing expertise, and insufficient geriatric content in nursing programs have created a national imperative to increase the supply of nurses qualified to provide care for older adults. Geriatric Nursing Education Consortium (GNEC), a collaborative program of the John A. Hartford Foundation, the American Association of Colleges of Nursing, and the New York University (NYU) Nursing Hartford Institute for Geriatric Nursing, was initiated to provide faculty with the necessary skills, knowledge, and competency to implement sustainable curricular innovations in care of older adults. This article describes the background, step-by-step process approach to the development of GNEC evidence-based curricular materials, and the dissemination of these materials through 6-, 2-, and a half-day national Faculty Development Institutes (FDIs). Eight hundred eight faculty, representing 418 schools of nursing, attended. A total of 479 individuals responded to an evaluation conducted by Baruch College that showed faculty feasibility to incorporate GNEC content into courses, confidence in teaching and incorporating content, and overall high rating of the GNEC materials. The impact of GNEC is discussed along with effects on faculty participants over 2 years. Administrative- and faculty-level recommendations to sustain and expand GNEC are highlighted. PMID:25455325

  5. The Faculty Learning About Geriatrics (FLAG) program: bringing together experts in geriatric nursing education.

    PubMed

    Edelstein, Janice A; Cheung, Corjena K; Voss, Jo A; Kaas, Merrie J

    2011-08-01

    Strengthening geriatric content in schools of nursing is a key initiative for the Minnesota Hartford Center of Geriatric Nursing Excellence. The first Faculty Learning About Geriatrics (FLAG) program was implemented in the summer of 2008. Selected nursing faculty from across the Upper Midwest and tribal colleges have successfully completed the FLAG program in the last 2 years. Participants completed a 5-day summer institute at the University of Minnesota and a 1-year mentorship program. The FLAG program is designed to broaden expertise in geriatric nursing through building teaching and academic leadership skills and to increase content knowledge through collaboration with academic and geriatric leaders. This article provides an overview of the educational experience of FLAG participants who have earned the title of FLAG program fellow. The perspectives of the FLAG mentors and fellows are highlighted. PMID:21598851

  6. What caring means to geriatric nurses.

    PubMed

    Shwu-Jiuan, Liu

    2004-06-01

    Caring is the major concept in nursing. The purpose of this study was to describe the meaning of caring for nurses caring for elderly patients. Parse' s phenomenology was addressed in the research design, which included four steps: participant selection, dialogical engagement, extraction-synthesis, and heuristic interpretation. By stratified sampling, 30 nurses who worked in medical-surgical wards in a general teaching hospital were selected as participants. Dialogical engagement was completed through in-depth, tape-recorded interviews on the open question, " What is the meaning of caring for you as a provider of care to the elderly? ". Data were interpreted by process of Parse' s phenomenology, which included extracting the essence, synthesizing the essence, formulating a proposition, extracting concepts, and structuring the meaning. The meaning of caring for nurses engaged in caring for the elderly was: " Through the initiative deliberation from sincerity, the nurse is to dedication by the empathy and tolerance". The core concepts of caring were: deliberation, initiative, sincerity, tolerance, empathy, and dedication. It should develop and apply the caring concept and theory actively to geriatric nursing care. PMID:15208778

  7. Intention of nursing students to work in geriatrics.

    PubMed

    Ben Natan, Merav; Danino, Sharon; Freundlich, Nelli; Barda, Ayelet; Yosef, Racheli Mor

    2015-01-01

    The current study examined factors related to nursing students' intention to work in geriatrics upon graduation. A cross-sectional, descriptive design was used. A random sample of 200 nursing students completed a questionnaire based on the Theory of Planned Behavior and Kogan's Attitudes Toward Old People Scale. Participants expressed low intention to work in geriatrics upon graduation. Results of a multiple linear regression indicated that students' attitudes toward working in geriatrics and normative and control beliefs were found to be predictors of this intention. Additionally, male and religious students were more inclined to work in geriatrics. The current study indicated that nursing students' attitudes toward working in geriatrics were significantly predictive of their intention to work in this field upon graduation. PMID:25707032

  8. Family Perceptions of Geriatric Foster Family and Nursing Home Care.

    ERIC Educational Resources Information Center

    Braun, Kathryn L.; Rose, Charles L.

    1987-01-01

    Relatives (N=62) of matched pairs of patients in geriatric foster homes and nursing homes rated care provided to their relatives. Significantly more foster family patients had positive pre-placement attitudes than did nursing home patients. Upon follow-up, relatives of foster patients reported seeing more patient improvement, satisfaction,…

  9. Geriatric Training Needs of Nursing-Home Physicians

    ERIC Educational Resources Information Center

    Lubart, Emily; Segal, Refael; Rosenfeld, Vera; Madjar, Jack; Kakuriev, Michael; Leibovitz, Arthur

    2009-01-01

    Medical care in nursing homes is not provided by board-licensed geriatricians; it mainly comes from physicians in need of educational programs in the field of geriatrics. Such programs, based on curriculum guidelines, should be developed. The purpose of this study was to seek input from nursing home physicians on their perceived needs for training…

  10. The Success and Struggles of Filipino Geriatric Nurses in Nursing Homes

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Coronel, Rona Denise V.; Chua, Kannerin O.; Constantino, Mariz G.; Cordova, Ericsann James C.

    2009-01-01

    Geriatric nursing is a physically and emotionally demanding job in healthcare. It is a neglected field despite the growing population of the elderly, and the experiences of geriatric nurses are one of the unrecognized aspects of this field. This qualitative study purports to explore the successes and struggles of the lived experiences of a select…

  11. Effects of a geriatric nurse practitioner on process and outcome of nursing home care.

    PubMed Central

    Kane, R L; Garrard, J; Skay, C L; Radosevich, D M; Buchanan, J L; McDermott, S M; Arnold, S B; Kepferle, L

    1989-01-01

    We compared measures of quality of care and health services utilization in 30 nursing homes employing geriatric nurse practitioners with those in 30 matched control homes. Information for this analysis came from reviews of samples of patient records drawn at comparable periods before and after the geriatric NPs were employed. The measures of geriatric nurse practitioner impact were based on comparisons of changes from pre-NP to post-NP periods. Separate analyses were done for newly admitted and long-stay residents; a subgroup of homes judged to be best case examples was analyzed separately as well as the whole sample. Favorable changes were seen in two out of eight activity of daily living (ADL) measures: five of 18 nursing therapies; two of six drug therapies; six of eight tracers. There was some reduction in hospital admissions and total days in geriatric NP homes. Overall measures of medical attention showed a mixed pattern with some evidence of geriatric NP care substituted for physician care. These findings suggest that the geriatric NP has a useful role in nursing home care. PMID:2504064

  12. An Innovative Continuing Nursing Education Program Targeting Key Geriatric Conditions for Hospitalized Older People in China

    ERIC Educational Resources Information Center

    Xiao, Lily Dongxia; Shen, Jun; Wu, Haifeng; Ding, Fu; He, Xizhen; Zhu, Yueping

    2013-01-01

    A lack of knowledge in registered nurses about geriatric conditions is one of the major factors that contribute to these conditions being overlooked in hospitalized older people. In China, an innovative geriatric continuing nursing education program aimed at developing registered nurses' understanding of the complex care needs of hospitalized…

  13. How Many Sides Does a Coin Have? A Phenomenology of Filipino Nurses' Motivation and Attitudes toward Geriatric Care

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Dangoy, Reena-Jane D.; David, Kathleen Christian V.; Dayo, Ken Jarrett H.; de Claro, Keisha A.; de Guzman, Giorgio von Gerri G.; de Jesus, Gerald Ian D.

    2009-01-01

    Nurses play a significant role in geriatric care. However, as the aging population and demand for geriatric nurses increase worldwide, shortages of nurses seem to arise. This creates the need to assess and address the motivation and attitudes of nurses toward geriatric care. The intent of this qualitative study is to surface the essence or the…

  14. Presentation and Management Outcomes of Corneal and Scleral Perforations in Geriatric Nursing Home Residents

    PubMed Central

    Ying Fong, Yoly Yeuk; Yu, Marco; Young, Alvin Lerrmann; Jhanji, Vishal

    2015-01-01

    Abstract We compared the clinical presentation and treatment outcomes of corneal and scleral perforations in geriatric nursing home residents, geriatric community residents, and non-geriatric population. The medical records of patients who were treated for corneal and scleral perforations at the Prince of Wales Hospital, Hong Kong between January 1, 2004 and May 1, 2013, were reviewed retrospectively. Of 144 cases, 53 (37%) occurred in the geriatric population, of which 16 (11%) lived in nursing homes, and 37 (26%) were community residents. There were 91 (63%) patients in the non-geriatric group. The mean age of the patients in nursing home geriatric group was 86.5 years (87.5% females). The most common etiology of perforation was trauma. Rupture due to fall was more common in geriatric patients (P < 0.001) whereas laceration due to penetrating eye injury was more common in non-geriatric patients (P < 0.001). There were more cases of infection leading to spontaneous perforation in geriatric nursing home group compared to the other groups (P = 0.001). In the geriatric nursing home group, visual acuity at presentation (P < 0.001) and postoperative visual acuity (P = 0.012) was worse compared to the other groups. Our study showed that corneal and scleral perforations in the geriatric nursing home residents carry a poor visual prognosis. The causes and anatomical outcomes of such events in geriatric age group differ from those in the general population. In our study, geriatric patients residing in nursing homes had worse baseline as well as posttreatment visual acuity, compared to community residents. PMID:26356724

  15. Physician and Nurse Acceptance of Technicians to Screen for Geriatric Syndromes in the Emergency Department

    PubMed Central

    Carpenter, Christopher R; Griffey, Richard T; Stark, Susan; Coopersmith, Craig M; Gage, Brian F

    2011-01-01

    Introduction The objective of this study was to evaluate emergency medicine physician and nurse acceptance of nonnurse, nonphysician screening for geriatric syndromes. Methods This was a single-center emergency department (ED) survey of physicians and nurses after an 8-month project. Geriatric technicians were paid medical student research assistants evaluating consenting ED patients older than 65 years for cognitive dysfunction, fall risk, or functional decline. The primary objective of this anonymous survey was to evaluate ED nurse and physician perceptions about the geriatric screener feasibility and barriers to implementation. In addition, as a secondary objective, respondents reported ongoing geriatric screening efforts independent of the research screeners. Results The survey was completed by 72% of physicians and 33% of nurses. Most nurses and physicians identified geriatric technicians as beneficial to patients without impeding ED throughput. Fewer than 25% of physicians routinely screen for any geriatric syndromes. Nurses evaluated for fall risk significantly more often than physicians, but no other significant differences were noted in ongoing screening efforts. Conclusion Dedicated geriatric technicians are perceived by nurses and physicians as beneficial to patients with the potential to improve patient safety and clinical outcomes. Most nurses and physicians are not currently screening for any geriatric syndromes. PMID:22224145

  16. [Nursing care and essential oils in geriatrics].

    PubMed

    Lobstein, Annelise; Marinier, Françoise

    2014-01-01

    Aromatherapy is a valuable complementary therapeutic tool which is increasingly being used in hospitals. Essential oils help to improve patients' quality of life. They can be used for well-being purposes as well in specific nursing procedures. Some services offer aromatherapy through diffusion, inhalation, massages or aromatic baths. The benefits for healthcare teams as well as for patients are undeniable. There is also a significant reduction in the consumption of certain drugs. PMID:25137964

  17. [Geriatric nursing staff retention. Opportunities, potentials, and strategies].

    PubMed

    Joost, A

    2013-08-01

    Retaining geriatric nurses in their line of work could be an important strategy to prevent the shortage of skilled staff in the future. A prerequisite for this is detailed knowledge of the length and structure of professional careers. The IWAK ( Institut für Wirtschaft, Arbeit und Kultur) evaluated data from the German Social Insurance and carried out a structural analysis of the professional careers of geriatric nurses. Results showed that the average duration of professional careers is 20 years, of which 11.7 years constitute the period of employment and 7.8 years account for periods of inactivity. According to these findings, there is a considerable potential in extending professional careers and reducing the periods of inactivity to make better use of the existing skilled staff and to reduce staff shortage in this area. Concrete measures could involve improvement of working conditions (with the aim of avoiding long periods of inactivity and illness-related premature career endings as well as of increasing job satisfaction), creating better conditions for a good balance between work and family life, as well as setting up individual strategies to expand weekly working hours. Key players are businesses but also local authorities and politicians. PMID:23884527

  18. Nursing dependency in registered nursing homes and long term care geriatric wards in Edinburgh.

    PubMed Central

    Capewell, A E; Primrose, W R; MacIntyre, C

    1986-01-01

    There has been growing interest and public investment in registered nursing homes, apparently based on the assumption that these homes are the private equivalent of hospital long term care. We have tested this hypothesis in a survey comparing 400 patients in 18 registered nursing homes with 217 patients in 11 geriatric long term care wards in Edinburgh. The nursing home patients formed a distinct and separate group: 362 (92%) were women, 392 (98%) were single or widowed, and 358 (90%) were self financing, whereas in the geriatric long term care group 148 (68%) were women and 35 (16%) were still married. Patients in nursing homes were also far less dependent than those in geriatric long term care wards (p less than 0.005). This study suggests that there may be large differences between the patients in these two types of institution, particularly with regard to nursing dependency. This finding has important implications in the future planning of long term places for the dependent elderly. PMID:3089370

  19. Filipino Nursing Students' Behavioral Intentions toward Geriatric Care: A Structural Equation Model (SEM)

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Jimenez, Benito Christian B.; Jocson, Kathlyn P.; Junio, Aileen R.; Junio, Drazen E.; Jurado, Jasper Benjamin N.; Justiniano, Angela Bianca F.

    2013-01-01

    Anchored on the key constucts of Ajzen's Theory of Planned Behavior (1985), this paper seeks to test a model that explores the influence of knowledge, attitude, and caring behavior on nursing students' behavioral intention toward geriatric care. A five-part survey-questionnaire was administered to 839 third and fourth year nursing students from a…

  20. [Gerontological and geriatric education in baccalaureate nursing degree: a national survey].

    PubMed

    Matarese, Maria; Quaggia, Giuliana

    2009-01-01

    Nowadays most nurses have to care for elderly people and in the future this will become always more frequent due to progressive ageing of population. Thus nurses will need to have the necessary skills so as to be able to answer to the many complex needs of this population. A national survey has been carried out to find out what kind of Gerontological education currently exists in Italian nursing degree courses. A questionnaire was sent out to all the coordinators/directors of the Nursing Schools in the 171 educational locations within the 38 Italian universities where the degree course was active during the academic year 2005/2006. 34 university (84.4%) and 88 of the 171 locations (51.4%) answered the questionnaire.A certain variety is present at national level for theoretical and clinical education in Geriatrics and Gerontology, in terms, for example, of number of credits, type of clinical placements and time in the curricula for the educational experiences; most Nursing Schools have specific courses dedicated to Geriatric/Gerontological contents. Moreover coordinators/directors believe that the space offered to Geriatrics education is enough and that overloading of the curriculum would be a more considerable obstacle to the introduction and to the increase of Geriatric content in the curricula. Although not all Italian Nursing Schools participated, this survey provides relevant information about present education offered in elderly care in Italy, and permits us to give useful suggestions to Italian educators and nursing tutors. PMID:20059890

  1. Incorporating geriatrics into baccalaureate nursing curricula: laying the groundwork with faculty development.

    PubMed

    Latimer, Deborah G; Thornlow, Deirdre K

    2006-01-01

    In June 2001, the John A. Hartford Foundation of New York awarded the American Association of Colleges of Nursing (AACN) a 3.99 million dollar grant to enhance gerontology curriculum development and new clinical experiences in 20 baccalaureate and 10 graduate schools of nursing. Over the 4-year grant implementation period, AACN learned a valuable lesson from the grant's site directors: Faculty development is the single most necessary precursor to the successful implementation and maintenance of geriatric curricular enhancements. Unless faculty members foster positive attitudes toward aging, expand their geriatric nursing knowledge base, and are able to integrate geriatric content into the curricula, progress cannot be made. Enhancing Geriatric Nursing Education project directors recommend that the following steps be taken toward the creation of successful faculty development activities: (1) anoint a champion to mentor and persuade faculty members to embrace gerontology; (2) garner faculty buy-in by engaging the faculty early so that they become active participants in the curricular change process; (3) assess faculty knowledge and comfort level by administering tools developed by the John A. Hartford Foundation Institute for Geriatric Nursing and by conducting surveys based on AACN geriatric core competencies; (4) conduct faculty development workshops that include cutting-edge knowledge and research and provide the faculty with opportunities to discuss feelings and stereotypes about aging; (5) elicit the dean's support to encourage and allow time and opportunities for training; and (6) use the many excellent resources that help the faculty integrate geriatric content into their courses. This article will further elucidate such strategies and will highlight the range of faculty development activities in which grant-funded schools engaged. PMID:16564471

  2. Task Analysis for Health Occupations. Cluster: Nursing. Occupation: Geriatric Aide. Education for Employment Task Lists.

    ERIC Educational Resources Information Center

    Lake County Area Vocational Center, Grayslake, IL.

    This task analysis for nursing education provides performance standards, steps to be followed, knowledge required, attitudes to be developed, safety procedures, and equipment and supplies needed for 13 tasks performed by geriatric aides in the duty area of performing diagnostic measures and for 30 tasks in the duty area of providing therapeutic…

  3. A survey of attitudes and perceptions toward oral hygiene among staff at a geriatric nursing home.

    PubMed

    Forsell, Marianne; Kullberg, Erika; Hoogstraate, Janet; Herbst, Bertil; Johansson, Olle; Sjögren, Petteri

    2010-01-01

    The aim of this survey was to test the impact of an oral hygiene educational model on attitudes and perceptions toward oral hygiene among nursing home staff members. A pilot questionnaire was distributed to the nursing staff before and after a course on oral hygiene at a geriatric nursing home in Stockholm in 2008. The nursing staff was of the opinion that they had sufficient time to carry out oral hygiene tasks but considered such tasks unpleasant, mainly because of unwillingness and resistance from the residents. These attitudes and perceptions among the nursing staff did not change significantly after oral hygiene education. Future oral hygiene educational models need to be developed with an aim to alter the perceptions and behavior of the nursing home staff. PMID:21035232

  4. Emotional competencies in geriatric nursing: empirical evidence from a computer based large scale assessment calibration study.

    PubMed

    Kaspar, Roman; Hartig, Johannes

    2016-03-01

    The care of older people was described as involving substantial emotion-related affordances. Scholars in vocational training and nursing disagree whether emotion-related skills could be conceptualized and assessed as a professional competence. Studies on emotion work and empathy regularly neglect the multidimensionality of these phenomena and their relation to the care process, and are rarely conclusive with respect to nursing behavior in practice. To test the status of emotion-related skills as a facet of client-directed geriatric nursing competence, 402 final-year nursing students from 24 German schools responded to a 62-item computer-based test. 14 items were developed to represent emotion-related affordances. Multi-dimensional IRT modeling was employed to assess a potential subdomain structure. Emotion-related test items did not form a separate subdomain, and were found to be discriminating across the whole competence continuum. Tasks concerning emotion work and empathy are reliable indicators for various levels of client-directed nursing competence. Claims for a distinct emotion-related competence in geriatric nursing, however, appear excessive with a process-oriented perspective. PMID:26108300

  5. Teaching massage to nursing students of geriatrics through active learning.

    PubMed

    Adler, Patricia A

    2009-03-01

    The use of massage in nursing practice has declined through the years in favor of high-tech interventions. This article describes a project using active learning to teach nursing students massage with dementia residents in assisted living. Students participated in a workshop to practice basic relaxation massage techniques with the guidance of their clinical instructor and then provided massages to resident volunteers. Afterward, students discussed their experience and completed a resident assessment form. The students requested more such activities, and the residents and facility management invited the students to return for another session. The instructor observed growth in the students' assessment skills and in their confidence. Use of massage to teach nursing students how to care for and relate to older adults with cognitive impairment is recommended. Further research is needed on the use of massage as an active learning method for nursing students in long-term care. PMID:19181909

  6. A Multi-Method Study of the Geriatric Learning Needs of Acute Care Hospital Nurses in Ontario, Canada.

    PubMed

    Fox, Mary T; Butler, Jeffrey I; Persaud, Malini; Tregunno, Deborah; Sidani, Souraya; McCague, Hugh

    2016-02-01

    Older people are at risk of experiencing functional decline and related complications during hospitalization. In countries with projected increases in age demographics, preventing these adverse consequences is a priority. Because most Canadian nurses have received little geriatrics content in their basic education, understanding their learning needs is fundamental to preparing them to respond to this priority. This two-phased multi-method study identified the geriatrics learning needs and strategies to address the learning needs of acute care registered nurses (RNs) and registered practical nurses (RPNs) in the province of Ontario, Canada. In Phase I, a survey that included a geriatric nursing knowledge scale was completed by a random sample of 2005 Ontario RNs and RPNs. Average scores on the geriatric nursing knowledge scale were in the "neither good nor bad" range, with RNs demonstrating slightly higher scores than RPNs. In Phase II, 33 RN and 24 RPN survey respondents participated in 13 focus group interviews to help confirm and expand survey findings. In thematic analysis, three major themes were identified that were the same in RNs and RPNs: (a) geriatric nursing is generally regarded as simple and custodial, (b) older people's care is more complex than is generally appreciated, and (c) in the current context, older people's care is best learned experientially and in brief on-site educational sessions. Healthcare providers, policy-makers, and educators can use the findings to develop educational initiatives to prepare RNs and RPNs to respond to the needs of an aging hospital population. PMID:26471253

  7. Development and Implementation of the Advanced Practice Nurse Worldwide With an Interest in Geriatric Care.

    PubMed

    Fougère, Bertrand; Morley, John E; Decavel, Frédérique; Nourhashémi, Fati; Abele, Patricia; Resnick, Barbara; Rantz, Marilyn; Lai, Claudia Kam Yuk; Moyle, Wendy; Pédra, Maryse; Chicoulaa, Bruno; Escourrou, Emile; Oustric, Stéphane; Vellas, Bruno

    2016-09-01

    Many countries are seeking to improve health care delivery by reviewing the roles of health professionals, including nurses. Developing new and more advanced roles for nurses could improve access to care in the face of a limited or diminishing supply of doctors and growing health care demand. The development of new nursing roles varies greatly from country to country. The United States and Canada established "nurse practitioners" (NPs) in the mid-1960s. The United Kingdom and Finland also have a long experience in using different forms of collaboration between doctors and nurses. In other countries, such as Australia, NPs were endorsed more recently in 2000. In France, Belgium, or Singapore, the formal recognition of advanced practice nurses is still in its infancy, whereas in other countries, such as Japan or China, advanced practice nurses are not licensed titles. The aims of this article were to define precisely what is meant by the term "advanced practice nurse (APN)," describe the state of development of APN roles, and review the main factors motivating the implementation of APN in different countries. Then, we examine the main factors that have hindered the development of APN roles. Finally, we explain the need for advanced practice roles in geriatrics. PMID:27321868

  8. Development of The Johns Hopkins University School of Nursing Adult/Geriatric Primary Care Nurse Practitioner Program in HIV Prevention, Treatment, and Care.

    PubMed

    Farley, Jason E; Stewart, Jennifer; Kub, Joan; Cumpsty-Fowler, Carolyn; Lowensen, Kelly; Becker, Kathleen

    2016-01-01

    In response to the call to create an AIDS Education and Training Center for Nurse Practitioner Education by the Health Resources and Services Administration, The Johns Hopkins University School of Nursing embarked on a transformative curriculum overhaul to integrate HIV prevention, treatment, and care into the Adult/Geriatric Nurse Practitioner Program. A six-step process outlined in the Curriculum Development for Medical Education was followed. A pilot cohort of Adult/Geriatric Nurse Practitioner students were enrolled, including 50% primary care setting and 50% HIV-focused primary care through a 12-month HIV continuity clinic experience. Through this pilot, substantive changes to the program were adopted. Programmatic outcomes were not compromised with the modification in clinical hours. The model of a 12-month HIV continuity clinical experience reduced the number of required preceptors. This model has important implications for the HIV workforce by demonstrating successful integration of HIV and primary care training for nurse practitioners. PMID:26852319

  9. Canadian Nursing Students and the Care of Older Patients: How Is Geriatric Nursing Perceived?

    PubMed

    Gould, Odette N; Dupuis-Blanchard, Suzanne; MacLennan, Anna

    2015-09-01

    The aim of this research was to contribute to an understanding about the professionalization of gerontological nursing. The specific objective was to explore attitudes about older people among undergraduate nursing students. Three focus groups were carried out with 3rd-year nursing students in a generalist program in a small Canadian city and discussions focused on experiences and attitudes surrounding the care of older patients. A qualitative descriptive approach was used to analyze the verbatim transcripts. Results indicated that students had positive reactions to caring for older patients, at least when dementia is not present, but they received a strong message from their mentors that this type of nursing is neither prestigious nor valued. Discussions surrounding the care of older adults highlighted students' perceptions of conflicts between the art and science of nursing, and their concerns regarding the divisions of tasks between nursing students, registered nurses, and licensed practical nurses. PMID:24652901

  10. IMPACT OF THE GERIATRIC MEDICATION GAME® ON NURSING STUDENTS EMPATHY AND ATTITUDES TOWARD OLDER ADULTS

    PubMed Central

    Kiersma, Mary E.; Yehle, Karen S.; Plake, Kimberly S.

    2014-01-01

    Background Nurses should be well-prepared to improve and address health-related needs of older adults, but students may have difficulty understanding and empathizing, as they may not yet have personally experienced aging-related challenges. Simulation games can be used to help students understand the experiences of others, but limited information is available on the impact of simulation experiences on student empathy. Objective The objective of this study was to examine the impact of participation in an aging simulation game on nursing students’ empathy and attitudes toward older adults as well as their understanding of patients’ experiences in the healthcare system. Design This study used a quasi-experimental, pretest-posttest design. Setting A school of nursing in the Midwestern United States. Participants The convenience sample included 58 sophomore-level baccalaureate nursing students. Methods Students played the role of an older adult during a 3-hour laboratory aging simulation game, the Geriatric Medication Game® (GMG). Students completed the (1) Kiersma-Chen Empathy Scale (KCES, 15 items, 7-point Likert-type), (2) Jefferson Scale of Empathy – Health Professions Students (JSE-HPS, 20 items, 7-point Likert-type), and (3) Aging Simulation Experience Survey (13 items, 7-point Likert-type) pre- and post-game to assess study objectives. Descriptive statistics and paired t-tests (were performed in SPSS v.21.0, as the data were normally distributed. Results Students’ empathy (N=58) toward older adults significantly improved overall (KCES p=0.015, JSE-HPS p<0.001). Improvements also were seen on seven out of 13 questions related to attitudes and healthcare understanding (p<0.05). In the post-test, students agreed that they experienced frustration and impatience during the GMG. Conclusions Students may not be aware of older adults’ feelings and experiences prior to experiencing aging-related changes themselves. Simulation activities, such as the GMG, can be

  11. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    PubMed Central

    2009-01-01

    Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices should be improved especially

  12. Doreen Norton OBE, MSc, SRN, FRCN (1922-2007): Pioneer who revolutionised pressure sore management and geriatric nursing to international acclaim.

    PubMed

    Denham, Michael J

    2016-05-01

    Doreen Norton was a delightful, widely respected nurse who devoted her life to improving the care of elderly people. She researched the neglected problem of pressure sores, revolutionised their nursing care, and thus achieved international fame. Her Pressure Sore Scale was established as a management tool and is still used today. She was a key member of the design team that produced the 'King's Fund Bed', researched equipment required on geriatric wards, assessed all geriatric long stay units in Scotland and established research as a valuable nursing tool within her profession and health authorities. She lectured extensively and her publications attracted worldwide acclamation. After her retirement, she was subsequently appointed to the world's first Chair of Gerontological Nursing in Cleveland, Ohio. PMID:26968512

  13. Use of a mobile device by nursing home residents for long-term care comprehensive geriatric self-assessment: a feasibility study.

    PubMed

    Huang, Fanpin; Chang, Polun; Hou, I-Ching; Tu, Ming-Hsiang; Lan, Chung-Fu

    2015-01-01

    Long-term-care comprehensive geriatric assessments, such as the Minimum Data Set 3.0, are used to evaluate the clinical, psychological, and personal status of residents in long-term-care nursing facilities. Nursing staff conducts assessment interviews, thereby increasing the workload of nurses and the cost of patient care. This study explored the ability of nursing home residents to use two different mobile devices for a geriatric self-assessment. Study participants were residents of long-term-care nursing homes. A modified Minimum Data Set 3.0 was converted to a format for use with a 6-inch mobile pad and a 3.7-inch mobile smartphone. The survey completion rate and the response time were measured. A Technology Assessment Model questionnaire analyzed the participants' experience. All participants were able to use a 6-inch pad, with an average completion rate of 92.9% and an average time for completion of 21 minutes. Only 20% of the participants could complete the assessment with the 3.7-inch smartphone. The participants found the 6-inch pad easier to use than the 3.7-inch smartphone. This exploratory study suggests that nursing home residents are able to use a mobile device to perform a geriatric self-assessment and delineates the importance of the ergonomics of the device. PMID:25397723

  14. Considerations for design of an e-learning program augmenting advanced geriatric nurse practitioner's clinical skills training.

    PubMed

    Rostad, Hanne M; Grov, Ellen Karine; Moen, Anne

    2014-01-01

    E-learning programs offer learners flexibility, more control over their learning experience, possibilities for repetition and allows for learning to be more individualized compared to traditional teaching methods. This paper presents considerations for an interdisciplinary project to design an e-learning program for graduate students enrolled in a master's program in Advanced Geriatric Nursing. The e-learning program offers new opportunities for learners to apply theoretical knowledge and develop their skills in the process of collaborative knowledge creation. A model based on the systematic development of instruction and learning and a pedagogical framework for e-learning has guided the design process. This paper explains how the e-learning program was created and how content was developed and implemented in an e-learning environment. PMID:24943556

  15. Practical Nursing Curriculum Advisory Committee Report Including Suggested Philosophy, Suggested Competencies, Geriatric Care Curriculum.

    ERIC Educational Resources Information Center

    Iowa Univ., Iowa City. Coll. of Education.

    A study was made of the current and future role of practical nurses and the curricula used to prepare these nurses in the 16 programs in Iowa. A statewide committee of 14 persons involved in hiring, employing, and controlling practical nurse practice was formed. Between Fall 1987 and Spring 1989, the committee gathered and analyzed information and…

  16. Developing positive attitudes toward geriatric nursing among Millennials and Generation Xers.

    PubMed

    Heise, Barbara A; Johnsen, Vickie; Himes, Deborah; Wing, Debra

    2012-01-01

    Despite the increase of the older adult population, there exists a shortage of health care professionals trained to help this population remain independent as long as possible. Ageism, common among younger adults, affects the capacity building of health care for older adults. Research has indicated that increased knowledge about older adults, as well as exposure to the elderly, may alter nursing students' attitudes regarding careers in gerontological nursing. However, questions remain as to what are the most effective ways to provide gerontological content in nursing programs and enhance attitudes toward older adults.With the understanding that younger adults see a need to balance work and play, a baccalaureate nursing program provides examples of ways to accomplish this through integration of courses, simulations, positive images of aging, and learning activities that enhance empathy for both frail and healthy older adults. PMID:22860477

  17. [Improvement of oral health care in geriatric care by training of nurses and nursing assistants for the elderly].

    PubMed

    Jordan, R; Sirsch, E; Gesch, D; Zimmer, S; Bartholomeyczik, S

    2012-04-01

    Because oral health among residents of German nursing homes is inadequate, this intervention study evaluated the effects of dental training for nurses and nursing assistants (RN and RA) in homes for the elderly on their assessment of oral health in residents and, as a consequence, on the status of residents' oral health. 53 residents and the RNs and RAs from three homes for the elderly participated in this study. The nursing staff received training in dental health care. As primary outcome, the competence in performing the Brief Oral Health Examination (BOHSE) was measured at baseline date and four months after training. Additional outcome measures were dental and denture hygiene in residents, functional status of dentures, and treatment needs. Dental training was shown to improve the nursing staff's competences in oral health assessment in tendency. Residents' oral hygiene improved significantly, whereas no relevant effects on hygiene and functional status of dentures were registered. The need for dental treatment turned out to be considerable at both measurements. Modifications in test tools with identification of dental treatment needs seem to be indicated in order to improve cooperation between nursing staff and dentists in homes for the elderly. PMID:22473733

  18. Emotional Competencies in Geriatric Nursing: Empirical Evidence from a Computer Based Large Scale Assessment Calibration Study

    ERIC Educational Resources Information Center

    Kaspar, Roman; Hartig, Johannes

    2016-01-01

    The care of older people was described as involving substantial emotion-related affordances. Scholars in vocational training and nursing disagree whether emotion-related skills could be conceptualized and assessed as a professional competence. Studies on emotion work and empathy regularly neglect the multidimensionality of these phenomena and…

  19. Nursing Home Social Workers and Allied Professionals: Enhancing Geriatric Mental Health Knowledge

    ERIC Educational Resources Information Center

    Bonifas, Robin P.

    2011-01-01

    Research has highlighted the challenges social services professionals face in providing quality psychosocial care to persons living in skilled nursing facilities (SNFs). A primary area of difficulty is addressing the needs of persons with mental health conditions, including problematic behaviors associated with dementia. This study evaluated the…

  20. Correlates of Geriatric Loneliness in Philippine Nursing Homes: A Multiple Regression Model

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Maravilla, Katrina N.; Maravilla, Veniza Anne M.; Marfil, Jomille D. V.; Marinas, Janine Angelica R.; Marquez, Jorelle Michael B.

    2012-01-01

    Numerous studies have been conducted worldwide about loneliness in older adults living in nursing homes and the factors associated with it. However, only a few studies have focused on social factors that may predispose these older adults to experience loneliness. The purpose of this study was to examine the interplay between and among loneliness,…

  1. Comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination to prevent functional decline in community-dwelling older persons: protocol of a cluster randomized trial

    PubMed Central

    2012-01-01

    Background Functional decline in community-dwelling older persons is associated with the loss of independence, the need for hospital and nursing-home care and premature death. The effectiveness of multifactorial interventions in preventing functional decline remains controversial. The aim of this study is to investigate whether functional decline in community-dwelling older persons can be delayed or prevented by a comprehensive geriatric assessment, multifactorial interventions and nurse-led care coordination. Methods/Design In a cluster randomized controlled trial, with the general practice as the unit of randomization, 1281 participants from 25 general practices will be enrolled in each condition to compare the intervention with usual care. The intervention will focus on older persons who are at increased risk for functional decline, identified by an Identification of Seniors at Risk Primary Care (ISAR-PC) score (≥ 2). These older persons will receive a comprehensive geriatric assessment, an individually tailored care and treatment plan, consisting of multifactorial, evidence-based interventions and subsequent nurse-led care coordination. The control group will receive 'care as usual' by the general practitioner (GP). The main outcome after 12 months is the level of physical functioning on the modified Katz-15 index score. The secondary outcomes are health-related quality of life, psychological and social functioning, healthcare utilization and institutionalization. Furthermore, a process evaluation and cost-effectiveness analysis will be performed. Discussion This study will provide new knowledge regarding the effectiveness and feasibility of a comprehensive geriatric assessment, multifactorial interventions and nurse-led elderly care in general practice. Trial registration NTR2653 Grant Unrestricted grant 'The Netherlands Organisation for Health Research and development' no 313020201 PMID:22462516

  2. Studying feasibility and effects of a two-stage nursing staff training in residential geriatric care using a 30 month mixed-methods design [ISRCTN24344776

    PubMed Central

    2011-01-01

    Background Transfer techniques and lifting weights often cause back pain and disorders for nurses in geriatric care. The Kinaesthetics care conception claims to be an alternative, yielding benefits for nurses as well as for clients. Starting a multi-step research program on the effects of Kinaesthetics, we assess the feasibility of a two-stage nursing staff training and a pre-post research design. Using quantitative and qualitative success criteria, we address mobilisation from the bed to a chair and backwards, walking with aid and positioning in bed on the staff level as well as on the resident level. In addition, effect estimates should help to decide on and to prepare a controlled trial. Methods/Design Standard basic and advanced Kinaesthetics courses (each comprising four subsequent days and an additional counselling day during the following four months) are offered to n = 36 out of 60 nurses in a residential geriatric care home, who are in charge of 76 residents. N = 22 residents needing movement support are participating to this study. On the staff level, measurements include focus group discussions, questionnaires, physical strain self-assessment (Borg scale), video recordings and external observation of patient assistance skills using a specialised instrument (SOPMAS). Questionnaires used on the resident level include safety, comfort, pain, and level of own participation during mobilisation. A functional mobility profile is assessed using a specialised test procedure (MOTPA). Measurements will take place at baseline (T0), after basic training (T1), and after the advanced course (T2). Follow-up focus groups will be offered at T1 and 10 months later (T3). Discussion Ten criteria for feasibility success are established before the trial, assigned to resources (missing data), processes (drop-out of nurses and residents) and science (minimum effects) criteria. This will help to make rational decision on entering the next stage of the research program. Trial

  3. Geriatrics: Profiles in Geriatrics

    MedlinePlus

    ... on the field. more info Todd Semla, Pharm D. Department of Veterans Affairs "I always liked working ... Rice University, a decade earlier. more info Marc D. Rothman, MD Chief Medical Officer, Kindred Healthcare Nursing ...

  4. [Nurses in geriatrics and Alzheimer's disease: knowledge, image, and common practice-results from a survey in a French area (Alsace)].

    PubMed

    Grosclaude, Michèle

    2007-06-01

    From the data of a multicentric investigation, performed in a French area (Alsace) using questionnaires filled by 800 geriatrics nurses, the author analyses their current knowledge and representations of Alzheimer's disease, their attitudes and practice concerning the disclosure of the diagnosis to the patients, and the influence of these data for the patients care. The results show three principal common aspects: first very important gaps, difficulties and contradictions concerning Alzheimer's disease knowledge; then heavy feelings of incompetence, loneliness, and therapeutic inanity with regard to the problems of their practice; last of all, their requests insisting on their need of information, formation, and aid, all missing for them. The nurses' language was devoid of specific and professional contents. It was similar to the general public, mediatic, and societal speeches, loaded with aprioristic assertions, reducing Alzheimer's disease to an organic process of humanity decline. This alarming picture calls to question its ground, mechanisms and solutions concerning the needs conveyed by the nurses, and the pertinency of the common concept of Alzheimer's disease. It enjoins to reconsider the nurses formation and a transdisciplinar further reflection about the notion of Alzheimer's disease and the messages which are transmitted by it. PMID:17556220

  5. Developing Leadership in Geriatric Education: An Annual Faculty Institute. Proceedings of the Summer Geriatric Institute (4th, Lexington, Kentucky, July 24-27, 1989).

    ERIC Educational Resources Information Center

    Gardner, Davis L., Ed.; Hoekelman, Margaret C., Ed.

    This document presents the proceedings of a conference on geriatric education. These papers are included: Promoting Healthy Aging: A Leadership Role for Geriatric Education; National Research Priorities in Aging; Aging with a Disability; Recent Advances in Clinical Strategies in Geriatric Education: The Role of the Geriatric Nurse in the Acute…

  6. Geriatric study in Europe on health effects of air quality in nursing homes (GERIE study) profile: objectives, study protocol and descriptive data

    PubMed Central

    2013-01-01

    Background Indoor air pollution (IAP) constitutes a major global public health problem requiring increasing efforts in research and policymaking that may have special significance for elderly that are likely to spend most of their day indoors and appear to be particularly susceptible to adverse effects of chemical pollutants and bio-contaminants. Yet, evidence existing on the effects of IAP in elderly is scanty. The Geriatric study in Europe on health effects of air quality in nursing homes (GERIE) study aimed to assess health effects of major indoor air pollutants and thermal conditions in elderly (> 70 years) living stably in nursing homes (NH) across Europe. Respiratory effects were particularly considered as airways and lung constitute the first target of air pollutants. Objectives We describe here the rationale and the methods of the GERIE Study. Methods 8 nursing homes were randomly selected in 7 European countries. Twenty individuals were randomly selected in each nursing home. Major indoor and outdoor air chemical pollutants (PM10, PM2.5, PM0.1, formaldehyde, NO2; O3, VOC, CO2) and bio-contaminants (moulds, allergens) were assessed objectively with standardized procedures. Major health status indicators were assessed through a standardized questionnaire, non-invasive clinical tests and blood and urine biomarkers as well as saliva for ADN. Results The GERIE study has given the opportunity to publish two reviews on respiratory health effects of indoor and outdoor air pollution in elderly. In addition it has provided the inventory of air quality and thermal conditions in 50 nursing homes across Europe and data on respiratory health status in 600 elderly aged 82 years in mean. Major future results will include the relationships between NH environment and health in elderly. Conclusions The main long-term purpose of the GERIE study is to improve the health of elderly who permanently reside in nursing homes or of those who are exposed to indoor air pollution

  7. Predictive values and other quality criteria of the German version of the Nurse-Work Instability Scale (Nurse-WIS) – follow-up survey findings of a prospective study of a cohort of geriatric care workers

    PubMed Central

    2014-01-01

    Background Until now there has been a lack of effective screening instruments for health care workers at risk. To counteract the forecast shortage for health care workers, the offer of early interventions to maintain their work ability will become a central concern. The Nurse-Work Instability Scale (Nurse-WIS) seems to be suitable as a screening instrument and therefore a prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS). Methods The follow-up data was used to test the sensitivity, specificity and the predictive values of the Nurse-WIS. The participants answered a questionnaire in the baseline investigation (T1) and in a follow-up 12 month after baseline. The hypothesis was that geriatric care workers with an increased risk according to the Nurse-WIS in T1 would be more likely to have taken long-term sick leave or drawn a pension for reduced work capacity in T2. Results 396 persons took part in T1 (21.3% response), 225 in T2 (42.3% loss-to-follow-up). In T1, 28.4% indicated an increased risk according to the Nurse-WIS. In T2, 10.2% had taken long-term sick leave or had drawn a pension for reduced work capacity. The sensitivity is 73.9% (95%-CI 55.7%–92.3%), the specificity is 76.7% (95%-CI 71.2%–82.8%). The ROC AUC indicated a moderate precision for the scale, at 0.74 (95%-CI 0.64–0.84). The PPV of the Nurse-WIS is 26.6%, and the NPV is 96.3%. For those with an increased risk according to the Nurse-WIS, the probability in T2 of long-term sick leave or a pension for reduced work capacity is around eight times higher (OR 8.3, 95%-CI 2.90–23.07). Persons who had indicated a long-term sick leave or made an application for a pension for reduced work capacity in T1 had a 17 times higher risk (OR 17.4, 95%-CI 3.34–90.55). Conclusion The German version of the Nurse-WIS appears to be a valid instrument with satisfactory predictive capabilities for recording an impending long

  8. Competencies in Geriatric Nursing: Empirical Evidence from a Computer-Based Large-Scale Assessment Calibration Study

    ERIC Educational Resources Information Center

    Kaspar, Roman; Döring, Ottmar; Wittmann, Eveline; Hartig, Johannes; Weyland, Ulrike; Nauerth, Annette; Möllers, Michaela; Rechenbach, Simone; Simon, Julia; Worofka, Iberé

    2016-01-01

    Valid and reliable standardized assessment of nursing competencies is needed to monitor the quality of vocational education and training (VET) in nursing and evaluate learning outcomes for care work trainees with increasingly heterogeneous learning backgrounds. To date, however, the modeling of professional competencies has not yet evolved into…

  9. Geriatric Trauma.

    PubMed

    Reske-Nielsen, Casper; Medzon, Ron

    2016-08-01

    Within the next 15 years, 1 in 5 Americans will be over age 65. $34 billion will be spent yearly on trauma care of this age group. This section covers situations in trauma unique to the geriatric population, who are often under-triaged and have significant injuries underestimated. Topics covered include age-related pathophysiological changes, underlying existing medical conditions and certain daily medications that increase the risk of serious injury in elderly trauma patients. Diagnostic evaluation of this group requires liberal testing, imaging, and a multidisciplinary team approach. Topics germane to geriatric trauma including hypothermia, elder abuse, and depression and suicide are also covered. PMID:27475011

  10. Geriatric Resuscitation.

    PubMed

    Perera, Thomas; Cortijo-Brown, Alexis

    2016-08-01

    The geriatric population makes up a large portion of the emergency patient population. Geriatric patients have less reserve and more comorbid diseases. They are frequently on multiple medications and are more likely to require aggressive treatment during acute illness. Although it may not be obvious, it is important to recognize the signs of shock as early as possible. Special care and monitoring should be used when resuscitating the elderly. The use of bedside ultrasound and monitoring for coagulopathies are discussed. Clinicians should be constantly vigilant and reassess throughout diagnosis and treatment. Ethical considerations in this population need to be considered on an individual basis. PMID:27475009

  11. Geriatric Technician.

    ERIC Educational Resources Information Center

    Seton Hill Coll., Greensburg, PA.

    This curriculum for training geriatric technicians is geared toward developing an understanding of, as well as the skills to assist with, the visually or hearing impaired older adult. The curriculum is organized in four modules. Each module is assigned a time frame and a credit unit base. The modules are divided into four major areas: knowledge,…

  12. Geriatric nutrition.

    PubMed

    Markham, R W; Hodgkins, E M

    1989-01-01

    In recent decades, veterinary medicine has become more successful in prolonging the healthy, useful lives of pets. As a result, the practitioner spends a greater part of each practice day caring for the geriatric animal, both healthy and unhealthy. Because of their longevity, older pets are typically regular family members, with owners who seek the finest health care possible for their pets. The practice of geriatric medicine most properly should begin not when the dog or cat reaches some specific "golden" age, but rather when the wiggly, robust puppy or kitten receives its first examination. Like all parts of a sound preventive program, geriatric nutrition best follows from a well-considered juvenile and adult nutrition program. Furthermore, once it becomes senior, the "well" geriatric is as much a candidate for a diet designed especially to accommodate old age changes as is his unhealthy contemporary. In fact, evidence suggests that appropriate dietary management of the healthy, but often subclinical, patient may help postpone the signs of dysfunction and increase quality and length of life. A knowledge of the most significant nutrients and the impact of each on aging systems is now, and will become increasingly more, important to the progressive, skillful veterinarian. PMID:2646815

  13. Isolation followed by integration: a model for development of a separate geriatric course.

    PubMed

    Wallace, Meredith; Lange, Jean; Grossman, Sheila

    2005-06-01

    Because of the growing population of older adults in America, nursing faculty throughout the United States have been consistently challenged during the past decade to use the most appropriate methods to strengthen geriatric content in baccalaureate nursing programs. The question of whether to integrate content throughout the curriculum or offer a stand-alone geriatric nursing course has been explored extensively, but no ultimate conclusion has been found. With the support of a grant for geriatric curriculum integration from the John A. Hartford Foundation, one university began the journey to integrate geriatric nursing curriculum throughout all baccalaureate nursing courses. However, at a curriculum evaluation meeting held halfway through the grant period, faculty expressed the need to have concentrated content earlier in the program that could serve as a foundation on which to build geriatric knowledge. Faculty unanimously voted to create a geriatric nursing course to be offered to students during their second year of baccalaureate study. PMID:16021801

  14. Integrating geriatric resources into the classroom: a virtual tour example.

    PubMed

    Bonnel, Wanda; Fletcher, Kathy; Wingate, Anita

    2007-01-01

    As the older adult population increases, nursing students at all levels need geriatric content and access to geriatric resources. The Virtual Tour (VT) assignment, a combination of Web-based geriatric resources and applied learning activities, provides a simple way to integrate Web-based resources into classroom learning. VTs provide students a guide or "road map" to practical Web-based resources for client care. Evaluation data support that students like VTs and gain useful information for practice. VTs provide an easy way to expand geriatric resources available to students and to complement classroom content. PMID:17923286

  15. [Palliative care - also in geriatrics?].

    PubMed

    Sandgathe Husebø, B; Husebø, S

    2001-10-01

    Red Cross Clinic is the largest geriatric center in Norway (240 beds). Major parts of the center are: long time geriatric ward (215 beds), rehabilitation and acute ward (25 beds), day clinic (45 patients) and a teaching and research unit. A palliative care unit (10 beds) will be opened in spring 2000. In mai 1998 a national project: Palliative care for the elderly was opened at our center. The projects main goal is to develop and support proper palliative care to all severe ill and dying patients in Norway. In a prospective study we examined 179 consecutive deaths between 1998 and 1999. Average age was 84.5. Major symptom problems were pain, dyspnoea, death-rattle and anxiety. In the last 24 hours 83% of the patients received opioids, 67% of the cases morphine (mean daily dosage 31.8 mg). 37% of the patients received scopolamine (mean daily dosage 0.8 mg), 12% benzodiazepines and 3% of the patients haloperidol. 152 (85%) of the deaths were expected, 27 (15%) unexpected. In 137 patients (77%) open, honest, frank communication with patient or their nearest kin regarding the imminent death was possible. In our experience it is a myth that the relatives want doctors to practise "maximal therapy". All old patients in geriatric clinics and nursing homes need palliative care. We have found no international textbooks of geriatrics with chapters on palliative care or textbooks on palliative care with chapters on the elderly. They need doctors and nurses who are properly trained and educated in palliative care. In most countries in Europe this training and education is not provided. PMID:11810376

  16. [Geriatric day hospital: what evidence? A systematic review].

    PubMed

    Petermans, Jean; Velghe, Anja; Gillain, Daniel; Boman, Xavier; Van Den Noortgate, Nele

    2011-09-01

    A systematic review of the international literature concerning the organisation of the Geriatric Day Hospital (GDH) was performed. From 1987 till now, few papers were found describing the activity and the effectiveness of the GDH. All the studies comparing specific geriatric approaches to regular medicine demonstrate the efficiency of geriatric care, particularly the geriatric assessment. So, with a degree of evidence 1a, a better outcome is found for patients undergoing a geriatric assessment and intervention, compared to patients having no geriatric assessment at all. However, there is no evidence of benefit for the geriatric day hospital compared to patients treated in a geriatric ward or other location of geriatric care. Moreover, there is no clear consensus on the settings and activities of a geriatric day hospital. Terms as day unit, day hospital, day care, are used interchangeably and are not always covering the same activity. The same remark can be made on the exact composition of the geriatric multidisciplinary team and its role. However nurses and paramedical workers are always mentioned as all performing geriatric assessment. The diagnostic activities on the GDH are seldom described and studied. More information is available on rehabilitation activity, often developed in specific patient populations such as stroke patients, dementia patients, cardiac patients or patients with other chronic diseases. In this selected patient populations positive effects on outcome are shown in the GDH (level of evidence 1a). Another problem is the heterogeneity of the population. For scientific reason the GDH should focus on organising care for specific medical problems. Diseases as dementia, stroke, cardiac insufficiency, could be good models to investigate the efficiency of geriatric assessment and interventions within the setting of a GDH. PMID:21896433

  17. Emerging geriatric challenge.

    PubMed

    Dhar, H L

    2005-10-01

    India is a vast country with diversity, both physical and cultural. 72% of World's second largest population live in rural experiencing varying degrees of socioeconomic change. However, there is no nationwide registry of older people and exact statistics about elderly population is not available. Community-based data on morbidity and disability are also not available. India is one of the few countries in the world where men out number women at all ages till about 70 years and only in very old age (80+) there are more women than men. One of the main social effect of extension of life in later years is the extended period of widowhood for women mainly due to cultural practice of men marrying younger women and widow marriage as well as divorce are uncommon. Much progress has been made in the health care services in the last 50 years giving much emphasis to mother and child programme with special emphasis on controlling population. But elderly population has been neglected, there is no separate ward for elderly in hospitals, no specialized courses in the Universities for training doctors and nurses for elderly care. Recently, Indian Medical Association has organized an ambitious project for rural elderly with emphasis on Geriatric care. Still recently, emphasis has been given for developing infrastructural facilities including creating training, courses on Geriatric Medicine and integrating with alternative system for better care of elderly. However, due to increasing awareness of policy makers to multiple issues related to aging, some progress has been made like old age pension scheme, income tax rebate for elderly, old homes and day care centers and law to help retired citizens in evicting tenants etc. but environment is not as elderly-friendly as in European countries, as the State is not likely to have adequate resources in the presence of other priorities in the country. PMID:16459531

  18. Inclusion of geriatric nutrition in ADA-approved undergraduate programs.

    PubMed

    Shoaf, L R; Jensen, H M

    1989-09-01

    All ADA Plan IV programs were surveyed to determine whether geriatric nutrition was included in their curriculums. Of the 268 Plan IV programs, 66% responded. Less than one-fifth of the programs offered or planned to offer a specific geriatric nutrition course. An overview of geriatric nutrition occurred most frequently in a human nutrition course. A practicum/clinical experience or a course other than nutrition most frequently provided in-depth study, if such was available. Nursing homes and congregate meal sites were the primary locations for experiences with the geriatric population. Major activities with that age group included (a) taking diet histories, (b) making nutrition assessments, and (c) providing diet instruction. In some programs, didactic and experiential training with the geriatric population may not be adequate to prepare dietetic undergraduate students to meet the health care needs of that growing segment of society. PMID:2768741

  19. [Geriatrics: an absolute necessity].

    PubMed

    Oostvogel, F J

    1982-02-01

    The medical care for elderly people could be greatly improved. If no specific attention is paid immediately, namely through the various training courses and by way of further and part-time schooling, then this medical care will remain unsatisfactory. This situation worsens continually due to the growing number of elderly people and, within this group, a much higher rate of very aged people. Increasing the care in institutions is altogether unsatisfactory. The problem should be dealt with structurally and the emphasis placed upon prevention and early-diagnosis. There is an urgent need for an integrated method, keeping in mind the limits of the elderly person, from the physical, psychological and social aspects. This demands teamwork in a multidisciplinary system inside as well as outside the institutions. It demands a thorough knowledge of geriatrics based upon gerontology. Geriatricians are urgently needed in this development together with doctors in nursing homes, general practitioners and specialists, so that the necessary care may be established as quickly as possible. PMID:7101393

  20. Geriatric rehabilitation on an acute-care medical unit.

    PubMed

    Jackson, M F

    1984-09-01

    This study examined a geriatric rehabilitation pilot project on an acute-care medical unit. Over a 6-week period, using a 35-item geriatric rating scale and a mental assessment tool, changes in behaviours of 23 patients admitted to the geriatric rehabilitation module were compared to changes in behaviours of 10 elderly patients on a regular medical unit. The patients' demographic characteristics, their nursing and medical diagnoses, and discharge patterns were reviewed. Significant changes in behaviours of patients on the rehabilitation model included: increased ability to care for themselves, to maintain balance, and to communicate with others; decreased restlessness at night; decreased confusion; decreased incidence of incontinence; and improved social skills. The paper describes the geriatric rehabilitation programme and discusses implications for nursing of elderly patients in acute-care hospitals. PMID:6567647

  1. [The need for training in gerontology and geriatrics among the staff providing services at a geriatric care institution].

    PubMed

    Baerga Duperoy, Rachel; Castro Rojas, Nydia; Orta Rodríguez, Brenda; González Caraballo, Enid; Cruz González, Angel; Vázquez Fernández, José; Oliver Vázquez, Marlén

    2002-12-01

    The purpose of this qualitative study was to explore and identify the basic training needs of nursing home staff, in terms of attitudes, knowledge and skills required to work effectively with geriatric patients. Three focus groups were performed, two groups of employees, and a group of elderly residents of the institution, in order to explore issues pertaining to the following topics: personal attributes required to work with geriatric patients, basic knowledge and skills needed to provide effective services. Group discussions were transcribed and themes were extracted through consensus reached by the investigators. Results indicated that the interviewed staff lack of formal preparation or continuing education in gerontology or geriatrics. Needs identified were the following: the aging process, caring behaviors, management of common health conditions, administration of medications, transference and mobility of residents, among others. Finding were use to design an educational program aimed in assisting nursing home staff in providing an effective service to their geriatric patients. PMID:12572242

  2. [Interprofessionalism in geriatrics].

    PubMed

    Mennel, Frédéric

    2014-01-01

    A system for the coordinated care of elderly people in geriatrics was set up at Luxembourg general hospital. The creation of the short-stay geriatric unit resulted in a reorganisation which questioned the notions of team, cohesion and skill. This article describes the successful experience and the benefit it has brought patients. PMID:25137960

  3. [Geriatrics - an interdisciplinary challenge].

    PubMed

    Nau, Roland; Djukic, Marija; Wappler, Manfred

    2016-06-01

    The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e.g. general practitioners, internists, neurologists and psychiatrists). In the training for the subspecialty clinical geriatrics, these specialties enjoy equal rights. Recent efforts to establish a qualification as physician for internal medicine and geriatrics have initiated a discussion to make the suitability for qualification as a geriatrician dependent on the medical specialty. Geriatric patients benefit from multidisciplinary cooperation. Neurologists possess great expertise in the treatment of patients with dementia, depression, delirium, consequences of degenerative spinal cord diseases and vertebral bone fractures, stroke, Parkinson's syndrome, epileptic seizures, vertigo and dizziness, neuropathies, lesions of peripheral nerves and in the multimodal therapy of pain. To function in a position of responsibility in a geriatric department, neurologists need skills in general internal medicine. These are acquired either on a geriatric ward or during specialization as a neurologist by full time secondment to large neurological or interdisciplinary intensive care units. PMID:27167886

  4. At the End of the Rainbow, Is There Always a Pot of Gold?: Understanding the Labor and Fervor of Filipino Geriatric Nurses

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Ching, Maria Ivana D.; Chiong, Edwin Mark L.; Chua, Charlene C.; Chua, Jason Eimer P.; Dumalasa, Michelle C.

    2009-01-01

    Background: Registered nurses (RNs) with specific knowledge and skills in the care of the aged are an important component in the delivery of quality health-care (Venturato, Kellet, & Windsor, 2006). These nurses experience both fervors of being in service and labor that challenge them, but which contribute to their provision of quality health care…

  5. Validation of the German version of the Nurse-Work Instability Scale: baseline survey findings of a prospective study of a cohort of geriatric care workers

    PubMed Central

    2013-01-01

    Background A prospective study of a cohort of nursing staff from nursing homes was undertaken to validate the Nurse-Work Instability Scale (Nurse-WIS). Baseline investigation data was used to test reliability, construct validity and criterion validity. Method A survey of nursing staff from nursing homes was conducted using a questionnaire containing the Nurse-WIS along with other survey instruments (including SF-12, WAI, SPE). The self-reported number of days’ sick leave taken and if a pension for reduced work capacity was drawn were recorded. The reliability of the scale was checked by item difficulty (P), item discrimination (rjt) and by internal consistency according to Cronbach’s coefficient. The hypotheses for checking construct validity were tested on the basis of correlations. Pearson’s chi-square was used to test concurrent criterion validity; discriminant validity was tested by means of binary logistic regression. Results 396 persons answered the questionnaire (21.3% response rate). More than 80% were female and mostly work full-time in a rotating shift pattern. Following the test for item discrimination, two items were removed from the Nurse-WIS test. According to Cronbach’s (0.927) the scale provides a high degree of measuring accuracy. All hypotheses and assumptions used to test validity were confirmed: As the Nurse-WIS risk increases, health-related quality of life, work ability and job satisfaction decline. Depressive symptoms and a poor subjective prognosis of earning capacity are also more frequent. Musculoskeletal disorders and impairments of psychological well-being are more frequent. Age also influences the Nurse-WIS result. While 12.0% of those below the age of 35 had an increased risk, the figure for those aged over 55 was 50%. Conclusion This study is the first validation study of the Nurse-WIS to date. The Nurse-WIS shows good reliability, good validity and a good level of measuring accuracy. It appears to be suitable for recording

  6. A National Survey on the Current Status of Family Practice Residency Education in Geriatric Medicine.

    ERIC Educational Resources Information Center

    Li, Ina; Arenson, Christine; Warshaw, Gregg; Bragg, Elizabeth; Shaull, Ruth; Counsell, Steven R.

    2003-01-01

    A survey of family practice residency directors found that 92 percent have a required geriatrics curriculum; nursing homes, assisted living facilities, and home care are the predominant training sites; the mean number of geriatrics faculty is 2.6 per program; and conflicting time demands with other curricula was ranked as the most significant…

  7. [The geriatric university clinic].

    PubMed

    Stähelin, H B

    1995-01-01

    The very old are the fastest growing population group. Medical progress allows more autonomy and better quality of life for the elderly. Traditional medical concepts are, however, only partly suited for dealing with age-associated problems. Medical education responds to these new requirements in a limited way. Interdisciplinary teamwork is a prerequisite in treating the multimorbid, acutely ill elderly patient. The task of the university is not only the development and implementation of high-tech medicine, but first of all a comprehensive training in medicine, including geriatrics. The Geriatric University Clinic therefore offers pre- and postgraduate training in geriatrics, but also in related disciplines by promoting teaching and research. In order to attain these goals, the geriatric acute ward was created for acutely ill, very old, multimorbid, frail elderly patients. A geriatric ward for rehabilitation complements this ward. A consultation service offers geriatric know-how to all other services. A special task is the early diagnosis and treatment of dementia in an outpatient service. The aim is to prevent chronification by early intervention and to reestablish satisfactory function and autonomy. PMID:7780809

  8. Current Trends in Geriatric Emergency Medicine.

    PubMed

    Kahn, Joseph H; Magauran, Brendan G; Olshaker, Jonathan S; Shankar, Kalpana N

    2016-08-01

    The number of geriatric visits to United States emergency departments continues to rise. This article reviews demographics, statistics, and future projections in geriatric emergency medicine. Included are discussions of US health care spending, geriatric emergency departments, prehospital care, frailty of geriatric patients, delirium, geriatric trauma, geriatric screening and prediction tools, medication safety, long-term care, and palliative care. PMID:27475008

  9. Geriatric Knowledge and Educational Needs among Rural Health Care Professionals.

    ERIC Educational Resources Information Center

    Goins, R. Turner; Gainor, Sara Jane; Pollard, Cecil; Spencer, S. Melinda

    2003-01-01

    In a needs assessment of 84 rural health care professionals (44.1% physicians, 15.5% pharmacists, 14.3% nurses, 26.1% other), 39% considered their geriatrics knowledge above average. They were interested in learning more about Alzheimer's/dementia, medication use, and adverse effects. Preferred methods were videotapes, CD-ROM, and an…

  10. Geriatric Medical Education in Israel

    ERIC Educational Resources Information Center

    Leibovitz, Arthur; Baumoehl, Yehuda; Habot, Beni

    2004-01-01

    In this article we will focus on geriatric medical education in Israel and will review our experience in this field. A coordinated effort of the Ministry of Health and the Israeli Medical Association led to the establishment of a modern geriatric system and to the recognition of geriatrics as a medical specialty in the early 1980s. All four…

  11. [Advances in geriatric cardiology].

    PubMed

    Gómez Sánchez, Miguel A; Bañuelos de Lucas, Camino; Ribera Casado, José M; Pérez Casar, Feliciano

    2006-01-01

    The continued aging of the population is an acknowledged fact. The proportion of individuals in the European Union aged over 65 years will reach 29.9% by 2050, almost double the present figure of 16.4%. Approximately one third of people in this age-group has clinically significant cardiovascular disease. Physicians dealing with cardiology in older patients have to be aware of the specific clinical and prognostic features of cardiovascular disease in the elderly, and with its treatment. Consequently, it is clear that continuing medical education in geriatric cardiology is essential, and that is one of the tasks of the Working Group on Geriatric Cardiology. This special issue provides a magnificent opportunity for presenting an update on important topics in geriatric cardiology, such as the aging of the cardiovascular system, heart failure, and atrial fibrillation. PMID:16540026

  12. Telepsychiatry and geriatric care.

    PubMed

    Jones, B N

    2001-02-01

    The use of telecommunications--telephone, computer, videoconferencing equipment--to provide mental health services at a distance has grown rapidly. This review encompasses reports from programs that provide telepsychiatry services, including telephone- and computer- based education and support services, telephone screening for dementia, and the use of videoconferencing to provide psychiatric consultations, health education, and administrative support. The extensive experience to date supports the value of telepsychiatry. Applications in geriatric settings and research involving geriatric subjects are reviewed. Cost analyses and economic evaluations of telepsychiatry are preliminary at this time and need further refinement. There is great potential for using telecommunications to expand access to mental health services to underserved geriatric populations. PMID:11177756

  13. Nutraceuticals for geriatrics.

    PubMed

    Gupta, Charu; Prakash, Dhan

    2015-01-01

    Geriatrics is a medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. Treatment of geriatric patients requires a different strategy and is very complex. Geriatric medicines aim to promote health by preventing and treating diseases and disabilities in older adults. Development of effective dietary interventions for promoting healthy aging is an active but challenging area of research because aging is associated with an increased risk of chronic disease, disability, and death. Aging populations are a global phenomenon. The most widespread conditions affecting older people are hypertension, congestive heart failure, dementia, osteoporosis, breathing problems, cataract, and diabetes to name a few. Decreased immunity is also partially responsible for the increased morbidity and mortality resulting from infectious agents in the elderly. Nutritional status is one of the chief variables that explains differences in both the incidence and pathology of infection. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating. Thus there is an urgent need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with aging. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. The present review thus focuses on the phytochemicals of nutraceutical importance for the geriatric population. PMID:26151003

  14. Nutraceuticals for geriatrics

    PubMed Central

    Gupta, Charu; Prakash, Dhan

    2014-01-01

    Geriatrics is a medical practice that addresses the complex needs of older patients and emphasizes maintaining functional independence even in the presence of chronic disease. Treatment of geriatric patients requires a different strategy and is very complex. Geriatric medicines aim to promote health by preventing and treating diseases and disabilities in older adults. Development of effective dietary interventions for promoting healthy aging is an active but challenging area of research because aging is associated with an increased risk of chronic disease, disability, and death. Aging populations are a global phenomenon. The most widespread conditions affecting older people are hypertension, congestive heart failure, dementia, osteoporosis, breathing problems, cataract, and diabetes to name a few. Decreased immunity is also partially responsible for the increased morbidity and mortality resulting from infectious agents in the elderly. Nutritional status is one of the chief variables that explains differences in both the incidence and pathology of infection. Elderly people are at increased risk for micronutrient deficiencies due to a variety of factors including social, physical, economic, and emotional obstacles to eating. Thus there is an urgent need to shift priorities to increase our attention on ways to prevent chronic illnesses associated with aging. Individually, people must put increased efforts into establishing healthy lifestyle practices, including consuming a more healthful diet. The present review thus focuses on the phytochemicals of nutraceutical importance for the geriatric population. PMID:26151003

  15. American Geriatrics Society

    MedlinePlus

    ... News Membership Contact Us Site Map About Us Health Care Professionals Advocacy Public Policy Public Education Featured "If you were asked to describe geriatrics using just three words, what would they be?" Now you can wear your words with ... Shop today! New Editorial & Virtual ...

  16. The portal of geriatrics online education: a 21st-century resource for teaching geriatrics.

    PubMed

    Ramaswamy, Ravishankar; Leipzig, Rosanne M; Howe, Carol L; Sauvigne, Karen; Usiak, Craig; Soriano, Rainier P

    2015-02-01

    The way students are taught and evaluated is changing, with greater emphasis on flexible, individualized, learner-centered education, including the use of technology. The goal of assessment is also shifting from what students know to how they perform in practice settings. Developing educational materials for teaching in these ways is time-consuming and can be expensive. The Portal of Geriatrics Online Education (POGOe) was developed to aid educators in meeting these needs and become quicker, better-prepared teachers of geriatrics. POGOe contains more than 950 geriatrics educational materials that faculty at 45% of allopathic and 7% of osteopathic U.S. medical schools and the Centers for Geriatric Nursing Excellence have created. These materials include various instructional and assessment methodologies, including virtual and standardized patients, games, tutorials, case-based teaching, self-directed learning, and traditional lectures. Materials with common goals and resource types are available as selected educational series. Learner assessments comprise approximately 10% of the educational materials. POGOe also includes libraries of videos, images, and questions extracted from its educational materials to encourage educators to repurpose content components to create new resources and to align their teaching better with their learners' needs. Web-Geriatric Education Modules, a peer-reviewed online modular curriculum for medical students, is a prime example of this repurposing. The existence of a robust compendium of instructional and assessment materials allows educators to concentrate more on improving learner performance in practice and not simply on knowledge acquisition. It also makes it easier for nongeriatricians to teach the care of older adults in their respective disciplines. PMID:25644187

  17. An international definition for "nursing home".

    PubMed

    Sanford, Angela M; Orrell, Martin; Tolson, Debbie; Abbatecola, Angela Marie; Arai, Hidenori; Bauer, Juergen M; Cruz-Jentoft, Alfonso J; Dong, Birong; Ga, Hyuk; Goel, Ashish; Hajjar, Ramzi; Holmerova, Iva; Katz, Paul R; Koopmans, Raymond T C M; Rolland, Yves; Visvanathan, Renuka; Woo, Jean; Morley, John E; Vellas, Bruno

    2015-03-01

    There is much ambiguity regarding the term "nursing home" in the international literature. The definition of a nursing home and the type of assistance provided in a nursing home is quite varied by country. The International Association of Gerontology and Geriatrics and AMDA foundation developed a survey to assist with an international consensus on the definition of "nursing home." PMID:25704126

  18. The Geriatrics in Primary Care Demonstration: Integrating Comprehensive Geriatric Care into the Medical Home: Preliminary Data.

    PubMed

    Engel, Peter A; Spencer, Jacqueline; Paul, Todd; Boardman, Judith B

    2016-04-01

    Three thousand nine hundred thirty-one veterans aged 75 and older receive primary care (PC) in two large practices of the Department of Veterans Affairs (VA) Boston Healthcare System. Cognitive and functional disabilities are endemic in this group, creating needs that predictably exceed available or appropriate resources. To address this problem, Geriatrics in Primary Care (GPC) embeds geriatric services directly into primary care. An on-site consulting geriatrician and geriatric nurse care manager work directly with PC colleagues in medicine, nursing, social work, pharmacy, and mental health within the VA medical home. This design delivers interdisciplinary geriatric care within PC that emphasizes comprehensive evaluations, care management, planned transitions, informed resource use, and a shift in care focus from multiple subspecialties to PC. Four hundred thirty-five veterans enrolled during the project's 4-year course. Complex, fragmented care was evident in a series of 50 individuals (aged 82 ± 7) enrolled during Months 1 to 6. The year before, these individuals made 372 medical or surgical subspecialty clinic visits (7.4 ± 9.8); 34% attended five or more subspecialty clinics, 48% had dementia, and 18% lacked family caregivers. During the first year after enrollment the mean number of subspecialty clinic visits declined significantly (4.7 ± 5.0, P = .01), whereas the number of PC-based visits remained stable (3.1 ± 1.5 and 3.3 ± 1.5, respectively, P = .50). Telephone contact by GPC (2.3 ± 2.0) and collaboration with PC clinicians replaced routine follow-up geriatric care. GPC facilitated planned transitions to rehabilitation centers (n = 5), home hospice (n = 2), dementia units (n = 3), and home care (n = 37). GPC provides efficient, comprehensive geriatric care and case management while preserving established relationships between patients and the PC team. Preliminary results suggest "care defragmentation," as reflected by a

  19. Applying comprehensive geriatric assessment to investigate falls.

    PubMed

    Rodgers, Geraldine

    2016-04-01

    This is the second article in a short series that presents case study examples of the use of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic assessment model designed to determine frail older people's medical and mental health status, as well as functional, social and environmental issues. When applied by nurses, it can enable individualised planning for health, safety and wellbeing. This article presents the case of an older man who had a three-month history of falls. After his most recent fall he was admitted to an emergency department, where examination identified no significant abnormal pathology, and subsequently to a nurse-led older person's clinic. The article describes how a CGA approach was adopted to assess the man, establish an underlying diagnosis of Parkinson's disease, and develop a personalised care plan to address immediate falls risk and long-term planning. PMID:27029990

  20. [COMPREHENSIVE GERIATRIC ASSESSMENT SCALES].

    PubMed

    Casado Verdejo, Inés; Postigo Mota, Salvador; Muñoz Bermejo, Laura; Vallejo Villalobos, José Ramón; Arrabal Léon, Nazaret; Pinto Montealegre, Jose Eduardo

    2016-01-01

    The process of comprehensive geriatric assessment is one of the key elements of geriatric care management aimed at the population. it includes evaluating the clinical, functional, mental and social aspects of aging result and/or pathological processes that appear at this stage of the life cycle. For their achievement, as well as other tools, professionals have a large number of validated rating scales specifically designed in the assessment of the different areas or fields. Its use can be very useful, especially for the objectification of evaluation results. The future of research in this area goes through deepening the adequacy of the scales to the characteristics and needs of older people in each care level or place of care. PMID:26996044

  1. Origins of British geriatrics.

    PubMed Central

    Howell, T. H.

    1976-01-01

    We may see from the foregoing account that British physicians have played a major part in the history of geriatric medicine. Other countries have no counterpart to J H Sheldon of Wolverhampton, whose work on the social medicine of old age was so fundamental, or George Adams of Belfast, to whom we owe such a debt of knowledge about cerebrovascular disease in the aged, or to Marjory Warren and the other pioneers mentioned above. Long may this tradition continue. PMID:785477

  2. Academic geriatrics in Singapore.

    PubMed

    Wong, Chek Hooi; Landefeld, C Seth

    2011-11-01

    Singapore is one of the fastest-aging countries in the world. The proportion of adults aged 65 and older is projected to increase from 8.7% to 20% over the next 20 years. The country has developed various strategies to meet the needs of this increase in older adults. There is an acute shortage of geriatricians and a need to train more healthcare workers to care for older adults. Geriatric medicine is a relatively new specialty, and a small number of geriatricians have been tasked with providing an increasing load of clinical service, education, and research. Hence, there is a need to develop a cohesive structure of support for faculty development and retention, advanced specialty trainee recruitment, leadership in medical education, research, and clinical service to care for the rapidly aging population. In addition, geriatric medicine is primarily a hospital-based specialty in Singapore. There is still opportunity to collaborate and improve the academic and practice integration of geriatric medicine into primary care and intermediate and long-term care where it is most needed. PMID:22091794

  3. [Urosepsis in Geriatric Patients].

    PubMed

    Heppner, H J; Yapan, F; Wiedemann, A

    2016-02-01

    Due to the demographic shift, increasing numbers of geriatric patients are admitted to acute care hospitals of all levels of care. This means that special challenges must be met in the medical care and management of these patients.Immunosenescence and multimorbidity make elderly patients vulnerable to infectious diseases. Urinary tract infections range from "simple" cystitis to pyelonephritis and urosepsis and, at 25%, are the second most common form of infection in geriatric patients. It is often difficult to make a diagnosis because typical symptoms do not always occur. Urosepsis, a hyperactive and uncontrolled immune response of the organism due to exogenous damage, is based on bacterial infection of the urogenital tract. Urinary retention, immunosuppressive medication, malignancy, diabetes mellitus and renal or prostatic processes promote the risk for urosepsis. Complicated urosepsis additionally comprises a structural or functional abnormality, including ureteral obstruction. Risk factors for urosepsis are urinary incontinence, an indwelling urinary catheter, hydronephrosis or ureteral calculi. Patients suffering from diabetes mellitus are also at a higher risk for urosepsis. When diagnosing elderly patients, one has to consider that the classic symptoms can be masked by multimorbidity, or septic encephalopathy and acute confusion (delirium) may be the only symptoms. Body temperature is lower in elderly patients and does not necessarily rise to 38°C or more in the acute phase. In patients older than 75 years who are suspicious for sepsis, temperatures as low as 37.4°C should be rated as fever. Treatment of urosepsis basically includes clearing the focus, antimicrobial treatment, stabilisation of circulation and replacement of failed organ functions. Initial empiric antibiotic treatment, depending on local resistance, should be done with acylaminopenicilline and beta-lactamase inhibitors (e. g. piperacillin/combactam or tazobactam or group 3 cephalosporins

  4. Factors That Impact Registered Nurses' Decisions to Continue Providing Care to Older Adults

    ERIC Educational Resources Information Center

    Bosfield, Saundra

    2013-01-01

    The purpose of this study was to investigate if there is a significant difference in the following: (a) nurses' likelihood to remain in geriatrics between age groups (those over 40 years of age and those under 40 years of age); (b) nurses' likelihood to remain in geriatrics and personality traits; (c) nurses' likelihood to remain in geriatrics…

  5. Do Geriatricians Stay in Geriatrics?

    ERIC Educational Resources Information Center

    Shah, Uday; Aung, Myo; Chan, Susanna; Wolfklein, Gisele

    2006-01-01

    To evaluate whether formally trained geriatricians remain in the field of Geriatrics, and to determine their job satisfaction and perceived quality of life, we surveyed the 107 fellows trained over the last 25 years in one accredited geriatric program. Of the 88 physicians who consented to participate, 75% devoted at least half of their practice…

  6. Geriatric assessment teams.

    PubMed

    Campbell, L J; Cole, K D

    1987-02-01

    In geriatric care, a form of teamwork is the recommended modality because of the complex biopsychosocial needs of the patient. The goal of geriatric assessment programs is to establish an intensive assessment of older adults which requires the competencies of several coordinated disciplines. Not only do teams have the capacity to assess patients in much greater depth but also patients share different information with different providers. The composition of the team is dictated by the needs of the patient population in accordance with resources available. Next, one must identify a method of team practice in order for interactions to take place. The method of functioning determines what kind of team it is, ranging from independent functioning with minimal formal interfacing to interdependent activity interspersed with formal and informal interactions. In initiating a geriatric assessment program, one needs to determine which tasks demand interdisciplinary collaboration, which require interdisciplinary consultation, and which can be performed using a matrix or extended team model. In this model, the core team is supplemented by other disciplines as determined by the team, predicated on patient problems. Teams can profit from training, which can help with choosing an appropriate model, establishing a manual of procedure, and managing interactive issues and problems. This can occur early in the team's formation, or when a team takes on new members. The minimal level of team development would include establishing program goals, delineating professional responsibilities and roles, and implementing a system for exchanging and documenting information about patient plans. Saving input to share only in team meeting is inefficient, so health care teams need to recognize the importance of informal interchanges. It is still a matter of conjecture about what team works best with which patients under what circumstances or conditions. Multiple randomized clinical trials with teams

  7. [Antipsychotics in geriatric institutions].

    PubMed

    Szulik, Judith

    2007-01-01

    The present paper approaches the use of antipsychotics in elder people in general, and particularly in geriatric institutions. During the last few years, prescription of antipsychotics in geriatric institutions increased, especially because of the availability of the atypicals, and their use was extended beyond the indications these drugs had been approved for. In dementia they are suggested for treatment of behavioral symptoms, despite having been approved only for cases of aggressiveness and risk of damage. There is a common tendency of perpetuating antipsychotic medication in elder people, with its consequent collateral effects as well. Few years ago, the increase of both risk of cerebrovascular events and of mortality in dementia patients treated with atypical agents was noticed. This generated controversy regarding their use in those kind of patients. Diverse factors associated to caregivers affect the decision of prescribing an antipsychotic in elder people. Non-pharmacological interventions are the first choice when treating behavioral symptoms; pharmacological interventions must take place with the lowest doses possible, with limited durations. PMID:18273435

  8. Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project.

    PubMed

    Buck, Harleah G; Kolanowski, Ann; Fick, Donna; Baronner, Lawrence

    2016-07-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ISSUE Instructions: 1.2 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded after you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. In order to obtain contact hours you must: 1. Read the article, "Improving Rural Geriatric Care Through Education: A Scalable, Collaborative Project," found on pages 306-313, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website to register for contact hour credit. You will be asked to provide your name, contact information, and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until June 30, 2019. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. OBJECTIVES Describe the unique nursing challenges that occur in caring for older adults in rural areas. Discuss the

  9. GRAMPS: An Automated Ambulatory Geriatric Record

    PubMed Central

    Hammond, Kenric W.; King, Carol A.; Date, Vishvanath V.; Prather, Robert J.; Loo, Lawrence; Siddiqui, Khwaja

    1988-01-01

    GRAMPS (Geriatric Record and Multidisciplinary Planning System) is an interactive MUMPS system developed for VA outpatient use. It allows physicians to effectively document care in problem-oriented format with structured narrative and free text, eliminating handwritten input. We evaluated the system in a one-year controlled cohort study. When the computer, was used, appointment times averaged 8.2 minutes longer (32.6 vs. 24.4 minutes) compared to control visits with the same physicians. Computer use was associated with better quality of care as measured in the management of a common problem, hypertension, as well as decreased overall costs of care. When a faster computer was installed, data entry times improved, suggesting that slower processing had accounted for a substantial portion of the observed difference in appointment lengths. The GRAMPS system was well-accepted by providers. The modular design used in GRAMPS has been extended to medical-care applications in Nursing and Mental Health.

  10. Spirituality in geriatric palliative care.

    PubMed

    Puchalski, Christina M

    2015-05-01

    This article presents an overview of spirituality as an essential domain of geriatrics palliative care, and provides guidelines for clinicians to diagnose spiritual distress and to integrate spirituality into their clinical practice. PMID:25920059

  11. Teaching Programs in Geriatric Optometry.

    ERIC Educational Resources Information Center

    Rosenbloom, Albert A.

    1985-01-01

    Results of a survey of U.S. and Canadian optometry programs concerning curriculum design, clinical and residency training programs, continuing education, and research projects planned or under way in geriatric optometry are presented and discussed. (MSE)

  12. Vital links. Hospital's geriatric program integrates the spectrum of care.

    PubMed

    Holt, T

    1989-06-01

    In July 1988 St. Mary Medical Center (SMMC), Long Beach, CA, established Older Adult Services (OAS) to help the elderly of the community. At the time, SMMC was already providing a number of services for the elderly, but OAS enables it to provide a continuum of care. In addition, the medical staff committee developing the geriatric program recommended establishing a geriatric assessment team headed by a fellowship-trained geriatrician, having that geriatrician serve as medical director of the inpatient skilled nursing facility (SNF), having the geriatric team develop treatment protocols in various aspects of care, and extending OAS within the community. The categories of service within the continuum are extended care, acute care, ambulatory care, home care, outreach, wellness, and housing. SMMC does not directly provide all services; rather, through integrating mechanisms, it uses community-based services or services provided by other institutions to meet some patient needs. A key element to integrating the continuum is the involvement of OAS in the SNF. The SNF medical director can bring the expertise of the geriatric assessment team to a wide sphere of the medical community. This sphere of influence quickly spreads to the hospital's entire medical community. Through direct participation in utilization review and quality assurance in the SNF, the OAS director can influence the quality of care. PMID:10293329

  13. Incorporating Geriatric Medicine Providers into the Care of the Older Adult with Cancer.

    PubMed

    Magnuson, Allison; Canin, Beverly; van Londen, G J; Edwards, Beatrice; Bakalarski, Pamela; Parker, Ira

    2016-11-01

    A significant proportion of cancer patients and survivors are age 65 and over. Older adults with cancer often have more complex medical and social needs than their younger counterparts. Geriatric medicine providers (GMPs) such as geriatricians, geriatric-trained advanced practice providers, and geriatric certified registered nurses have expertise in caring for older adults, managing complex medical situations, and optimizing function and independence for this population. GMPs are not routinely incorporated into cancer care for older adults; however, their particular skill set may add benefit at many points along the cancer care continuum. In this article, we review the role of geriatric assessment in the care of older cancer patients, highlight specific case scenarios in which GMPs may offer additional understanding and insight in the care of older adults with cancer, and discuss specific mechanisms for incorporating GMPs into oncology care. PMID:27613166

  14. Trauma in the geriatric population.

    PubMed

    Maxwell, Cathy A

    2015-06-01

    Injury in older adults is a looming public health crisis. This article provides a broad overview of geriatric trauma across the continuum of care. After a review of the epidemiology of geriatric trauma, optimal approaches to patient care are presented for triage and transport, trauma team activation and initial assessment, inpatient management, and injury prevention. Special emphasis is given to assessment of frailty, advanced care planning, and transitions of care. PMID:25981722

  15. Nurses' Learning Experiences with the Kinaesthetics Care Concept Training in a Nursing Home: A Qualitative Descriptive Study

    ERIC Educational Resources Information Center

    Fringer, André; Huth, Martina; Hantikainen, Virpi

    2015-01-01

    In geriatric care, movement support skills of nurses are often limited, resulting in unnecessary functional decline of older adult residents and physical strain of nurses. Kinaesthetics training aims to improve movement competences of nurses and residents. The aim of this qualitative descriptive study is to describe nursing teams' experience with…

  16. Mobilizing gerontological nursing education: The GNEC Podcast Project.

    PubMed

    Aselage, Melissa

    2010-07-01

    Capturing baccalaureate nursing student interest in gerontological nursing content can be challenging. Using technology, a joint project based on the Geriatric Nursing Education Consortium (GNEC) modules produced podcasts focused on nine major topics of care for older adults: atypical presentation, cancer, critical thinking, dementia, diabetes, geriatric resources, heart disease, intensive care, and interdisciplinary teams. Each podcast lays a foundation of content for faculty to build on in the classroom and at the bedside. PMID:20608595

  17. Geriatric dentistry education in European dental schools.

    PubMed

    Preshaw, P M; Mohammad, A R

    2005-05-01

    As the numbers of elderly adults continue to grow within European populations, the need for dental students to be trained in the management of geriatric patients becomes increasingly important. Many dental schools have developed training programmes in geriatric dentistry in response to the changing oral health needs of older adults. The purpose of this on-line survey was to identify the current status of geriatric dentistry education in European dental schools. A questionnaire relating to the teaching of geriatric dentistry was posted on the Internet, and 194 dental schools in 34 European countries were invited to participate. Data from completed questionnaires were submitted to the investigators via email from 82 schools in 27 countries (42% response rate). Thirty-six percent of schools offered a specific geriatric dentistry course that included didactic teaching or seminar groups, 21% taught geriatric dentistry by means of organised presentations in the curriculum, and 36% taught the subject by occasional lectures. 7% of schools did not teach geriatric dentistry at all. A clinical component to the geriatric dentistry curriculum was reported by 61% of schools and 18% reported operating a specific geriatric dentistry clinic within the school. Of those providing clinical geriatric dentistry training, it was provided within the school in 45% of cases, with a further 29% of schools providing training both within the school and at a remote location. Seven percent of schools operated a mobile dental clinic for treating geriatric patients. Twenty-eight percent of schools had a geriatric programme director or a chairman of a geriatric section and 39% indicated that they plan to extend the teaching of geriatric dentistry in the future. Geriatric dental education has clearly established itself in the curricula of European dental schools although the format of teaching the subject varies widely. It is of concern that geriatric dentistry was not taught at all in 7% of schools

  18. Hartford Gerontological Nursing Leaders: From Funding Initiative to National Organization.

    PubMed

    Van Cleave, Janet H; Szanton, Sarah L; Shillam, Casey; Rose, Karen; Rao, Aditi D; Perez, Adriana; O'Connor, Melissa; Walker, Rachel; Buron, Bill; Boltz, Marie; Bellot, Jennifer; Batchelor-Murphy, Melissa

    2016-01-01

    In 2000, the John A. Hartford Foundation established the Building Academic Geriatric Nursing Capacity Program initiative, acknowledging nursing's key role in the care of the growing population of older adults. This program has supported 249 nurse scientists with pre- and postdoctoral awards. As a result of the program's success, several Building Academic Geriatric Nursing Capacity Program awardees formed an alumni organization to continue to advance the quality care of older adults. This group of Building Academic Geriatric Nursing Capacity Program awardees joined others receiving support from the John A. Hartford Foundation nursing initiatives to grow a formal organization, the Hartford Gerontological Nursing Leaders (HGNL). The purpose of this article is to present the development, accomplishments, and challenges of the HGNL, informing other professional nursing organizations that are experiencing similar accomplishments and challenges. This article also demonstrates the power of a funding initiative to grow an organization dedicated to impact gerontological health and health care through research, practice, education, and policy. PMID:26802588

  19. A Graduate Nursing Curriculum for the Evaluation and Management of Urinary Incontinence

    ERIC Educational Resources Information Center

    Rogalski, Nicole

    2005-01-01

    Geriatric nurse practitioners should be educated in the evaluation and treatment of common geriatric syndromes like urinary incontinence. However, many advanced-practice nursing programs do not place an educational emphasis on urinary incontinence management. The purpose of this project is to provide information that supports the need for…

  20. Models of Care in Geriatric Oncology

    PubMed Central

    Magnuson, A.; Dale, W.; Mohile, S.

    2014-01-01

    Cancer is common in older adults and the approach to cancer treatment and supportive measures in this age group is continuously evolving. Incorporating geriatric assessment (GA) into the care of the older patient with cancer has been shown to be feasible and predictive of outcomes, and there are unique aspects of the traditional geriatric domains that can be considered in this population. Geriatric assessment-guided interventions can also be developed to support patients during their treatment course. There are several existing models of incorporating geriatrics into oncology care, including a consultative geriatric assessment, geriatrician “embedded” within an oncology clinic and primary management by a dual-trained geriatric oncologist. Although a geriatrician or geriatric oncologist leads the geriatric assessment, is it truly a multidisciplinary assessment, and often includes evaluation by a physical therapist, occupational therapist, pharmacist, social worker and nutritionist. PMID:25587518

  1. [Geriatric Authority of Holyoke Workplace Literacy Project.] Final Report. Final Evaluation Report.

    ERIC Educational Resources Information Center

    Massachusetts Career Development Inst., Springfield.

    This final report documents the development of a workplace literacy program for 100 employees of the Geriatric Authority of Holyoke, Massachusetts (GAH), a major nonprofit nursing home and rehabilitation facility. It describes how GAH employees received instruction in English as a Second Language, adult basic education, and General Educational…

  2. Geriatric Foot Care: A Model Educational Program for Mid-Level Practitioners.

    ERIC Educational Resources Information Center

    Suggs, Patricia K.; Krissak, Ruth; Caruso, Frank; Teasdall, Robert

    2002-01-01

    An educational program on geriatric foot care was completed by 59 nurse practitioners, 12 physicians' assistants, and 1 physician. The 3 1/2 day program included interactive sessions, observation, and hands-on patient care. Posttest results and 6-month follow-up showed significant knowledge increases and incorporation of learning into practice.…

  3. Effects of a Geriatrics Interdisciplinary Experience on Learners' Knowledge and Attitudes

    ERIC Educational Resources Information Center

    Fitzgerald, James T.; Williams, Brent C.; Halter, Jeffrey B.; Remington, Tami L.; Foulk, Mariko A.; Persky, Neal W.; Shay, Barbara R.

    2006-01-01

    This study examines the impact of an interdisciplinary training program on knowledge and attitudes of learners from four health care programs: medicine, pharmacy, social work, and nursing. Sixty-two learners participated in a 4-day educational program (one day each week for 4 weeks) focusing on interdisciplinary geriatric care. After completing…

  4. 28 CFR 2.78 - Geriatric parole.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 28 Judicial Administration 1 2012-07-01 2012-07-01 false Geriatric parole. 2.78 Section 2.78... Geriatric parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that a... Commission shall determine whether or not to release the prisoner on geriatric parole. Release on...

  5. 28 CFR 2.78 - Geriatric parole.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... 28 Judicial Administration 1 2014-07-01 2014-07-01 false Geriatric parole. 2.78 Section 2.78... Geriatric parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that a... Commission shall determine whether or not to release the prisoner on geriatric parole. Release on...

  6. 28 CFR 2.78 - Geriatric parole.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... 28 Judicial Administration 1 2013-07-01 2013-07-01 false Geriatric parole. 2.78 Section 2.78... Geriatric parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that a... Commission shall determine whether or not to release the prisoner on geriatric parole. Release on...

  7. 28 CFR 2.78 - Geriatric parole.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... 28 Judicial Administration 1 2011-07-01 2011-07-01 false Geriatric parole. 2.78 Section 2.78... Geriatric parole. (a) Upon receipt of a report from the institution in which the prisoner is confined that a... Commission shall determine whether or not to release the prisoner on geriatric parole. Release on...

  8. FUNCTIONAL NEUROIMAGING IN GERIATRIC DEPRESSION

    PubMed Central

    Gunning, Faith M.; Smith, Gwenn S.

    2012-01-01

    Synopsis Abnormalities in specific cerebral networks likely confer vulnerability that increases the susceptibility for development of geriatric depression and impact the course of symptoms. Functional neuroimaging enables the in vivo identification of alterations in cerebral function that not only characterize disease vulnerability, but also may contribute to variability in depressive symptoms and antidepressant response. Judicious use of functional neuroimaging tools can advance pathophysiological models of geriatric depression. Furthermore, due to the age-related vulnerability of specific brain systems that have been implicated in mood disorders, geriatric depression provides a logical context within which to study the role of specific functional abnormalities in both antidepressant response and key behavioral and cognitive abnormalities of mood disorders. PMID:21536165

  9. Neuromodulation therapies for geriatric depression.

    PubMed

    Gálvez, Verònica; Ho, Kerrie-Anne; Alonzo, Angelo; Martin, Donel; George, Duncan; Loo, Colleen K

    2015-07-01

    Depression is frequent in old age and its prognosis is poorer than in younger populations. The use of pharmacological treatments in geriatric depression is limited by specific pharmacodynamic age-related factors that can diminish tolerability and increase the risk of drug interactions. The possibility of modulating cerebral activity using brain stimulation techniques could result in treating geriatric depression more effectively while reducing systemic side effects and medication interactions. This may subsequently improve treatment adherence and overall prognosis in the older patient. Among clinically available neuromodulatory techniques, electroconvulsive therapy (ECT) remains the gold standard for the treatment of severe depression in the elderly. Studies have proven that ECT is more effective and has a faster onset of action than antidepressants in the treatment of severe, unipolar, geriatric depression and that older age is a predictor of rapid ECT response and remission. The application of novel and more tolerable forms of ECT for geriatric depression is currently being examined. Preliminary results suggest that right unilateral ultrabrief ECT (RUL-UB ECT) is a promising intervention, with similar efficacy to brief-pulse ECT and fewer adverse cognitive effects. Overall findings in repetitive transcranial magnetic stimulation (rTMS) suggest that it is a safe intervention in geriatric depression. Higher rTMS stimulation intensity and more treatments may need to be given in the elderly to achieve optimal results. There is no specific data on vagus nerve stimulation in the elderly. Transcranial direct current stimulation, magnetic seizure therapy and deep brain stimulation are currently experimental, and more data from geriatric samples is needed. PMID:25995098

  10. Geriatric assessment for oncologists

    PubMed Central

    Korc-Grodzicki, Beatriz; Holmes, Holly M.; Shahrokni, Armin

    2015-01-01

    The world is experiencing aging of its population. Age-specific incidence rates of cancer are higher and cancer is now recognized as a part of aging. Treating older patients can be challenging. The clinical behavior of some tumors changes with age and the aging process itself brings physiological changes leading to decline in the function of organs. It is essential to identify those patients with longer life expectancy, potentially more likely to benefit from aggressive treatment vs. those that are more vulnerable to adverse outcomes. A primary determination when considering therapy for an older cancer patient is a patient’s physiologic, rather than chronologic age. In order to differentiate amongst patients of the same age, it is useful to determine if a patient is fit or frail. Frail older adults have multiple chronic conditions and difficulties maintaining independence. They may be more vulnerable to therapy toxicities, and may not have substantial lasting benefits from therapy. Geriatric assessment (GA) may be used as a tool to determine reversible deficits and devise treatment strategies to mitigate such deficits. GA is also used in treatment decision making by clinicians, helping to risk stratify patients prior to potentially high-risk therapy. An important practical aspect of GA is the feasibility of incorporating it into a busy oncology practice. Key considerations in performing the GA include: available resources, patient population, GA tools to use, and who will be responsible for using the GA results and develop care plans. Challenges in implementing GA in clinical practice will be discussed. PMID:26779363

  11. American Geriatrics Society/Association of Directors of Geriatric Academic Programs curricular milestones for graduating geriatric fellows.

    PubMed

    Parks, Susan M; Harper, G Michael; Fernandez, Helen; Sauvigne, Karen; Leipzig, Rosanne M

    2014-05-01

    This article describes the curricular milestones for geriatric fellows and the process used to develop them. The curricular milestones were developed to determine what every graduating geriatric fellow should be able to demonstrate to ensure that they will be able to practice effectively and safely in all care settings and with different older adult populations. Three major domains were identified: Caring for the Elderly Patient, Systems-Based Care for Elder Patients, and Geriatric Syndromes. Six hundred thirty-five geriatricians each reviewed and commented on one domain. These geriatricians represented important stakeholder groups: geriatric fellowship program directors; Association of Directors of Geriatric Academic Programs (ADGAP) members, who are primarily geriatric program and fellowship directors; the American Geriatrics Society (AGS) and ADGAP Education Committee; the AGS Teacher's Section; Geriatric Academic Career Award awardees; and through the American Board of Internal Medicine and the American Board of Family Medicine, board-certified geriatricians who spend more than 50% of their time in clinical practice. The AGS and ADGAP boards approved the final set of 76 Geriatric Curricular Milestones, which were posted on the Portal of Geriatric Online Education in December 2012. These curricular milestones are intended to assist geriatric fellowship directors as they develop curricula and assessments to inform program director reporting to the Accreditation Council for Graduate Medical Education in the Next Accreditation System, which begins in July 2014. PMID:24749808

  12. How Much is Geriatric Caregivers Burnout Caring-Specific? Questions from a Questionnaire Survey

    PubMed Central

    Cocco, Ennio

    2010-01-01

    Summary: Background and Aims: Research dealing with occupational strain and burnout in geriatric care is generally focused on the behavioral problems of the patient and/or the psychological traits or attitudes of the carers rather than on organizational functionality. This paper describes data from a survey of all geriatric professions, using the Stressful Events Questionnaire (SEQ), a tool that takes into account multiple dimensions that can affect the genesis of burnout, including the patient, the geriatric health care professional, and the health care organization. The aim of this study is to compare patterns of answers among different roles in geriatric care. Method: Patterns of SEQ answers are described for the entire sample as well as for workers experiencing burnout and for each caring profession investigated: certified nursing assistants (CNAs), registered nurses and physicians/psychologists. Results; In general, carers refer more often as stressful the facility-related events; the only exception is that CNAs working in general hospital geriatric wards refer most often as stressful the patient-related events. The self-related events area seems to have a great importance for all professions. Discussion: The specificity of gerontological burnout has to be discussed, to better define the role played by caring problems, including psychological attitudes of carers versus the role played by the institution and by the social situation of each worker. For CNAs, the interaction between educational background and the length of time spent as a CNA seems to be a critical topic. PMID:20835358

  13. Early Walking of Geriatric Amputees

    PubMed Central

    Devas, M. B.

    1971-01-01

    After amputation geriatric patients have been enabled to get up and walk with the help of a prosthesis, an “early walking aid.” The physiotherapist measures the patient, fits the early walking aid, and instructs him in walking. The prosthesis is simple to make, easy to apply, and allows early walking with the use of a walking frame or sticks. Thus the geriatric amputee can walk as soon after operation as his general condition allows and the surgeon wishes. ImagesFIG. 1FIG. 2 PMID:5100378

  14. Supervisory Skills for Geriatric Care.

    ERIC Educational Resources Information Center

    Nelson, Frank W.

    Designed for training supervisors in nursing centers, this publication presents three units of study: (1) getting along with people in nursing centers, (2) supervision in nursing centers, and (3) communication in nursing centers. Each unit contains five types of material on separate, removable sheets: (1) sheets with unit objectives and suggested…

  15. Teaching interdisciplinary geriatrics ambulatory care: a case study.

    PubMed

    Williams, Brent C; Remington, Tami L; Foulk, Mariko A; Whall, Ann L

    2006-01-01

    Interdisciplinary health care training is advocated by numerous government and philanthropic organizations. Educators in the health professions are increasingly offering training in interdisciplinary health care in a variety of contexts, including ambulatory settings. This paper describes a three-year program to teach skills in interdisciplinary care to learners from internal medicine, social work, pharmacy, and nursing in a geriatrics clinic at a major academic institution in the United States. Framed in a critical review of existing evidence for the effectiveness of interdisciplinary training and health care and expert recommendations, specific recommendations are made to educators interested in interdisciplinary training in ambulatory settings. PMID:16446270

  16. Virtual Patients in Geriatric Education

    ERIC Educational Resources Information Center

    Tan, Zaldy S.; Mulhausen, Paul L.; Smith, Stephen R.; Ruiz, Jorge G.

    2010-01-01

    The virtual patient is a case-based computer program that combines textual information with multimedia elements such as audio, graphics, and animation. It is increasingly being utilized as a teaching modality by medical educators in various fields of instruction. The inherent complexity of older patients and the shortage of geriatrics educators…

  17. Geriatric Optometry Programs of Promise.

    ERIC Educational Resources Information Center

    Verma, Satya B.

    1985-01-01

    The curriculum design, philosophy, and innovation of four programs in geriatric optometry are described: the Pennsylvania College of Optometry and the colleges of Optometry at the State University of New York, University of Alabama at Birmingham, and University of Houston. (MSE)

  18. Geriatric medical education: developments since the American Geriatrics Society Conferences on Geriatric Education, 1976-77.

    PubMed

    Reichel, W

    1981-01-01

    This is a Report presented to and endorsed by the Board of Directors of the American Geriatrics Society (AGS). It deals with developments since the AGS Conferences on Geriatric Education, 1976-77. Summarized is the position adopted by various medical organizations and associations, including the Institute of Medicine, Federated Council for Internal Medicine, American Society of Internal Medicine, and the American Academy of Family Physicians. Their stances essentially agree with that described in the Proceedings of the 1976-77 Conferences (JAGS, November 1977). The consensus arising from discussions by organized medical groups is that creation of a new practice specialty is unnecessary, although development and maintenance of an academic cadre of teachers and researchers is essential. Called for is greater commitment at the medical school level to incorporate geriatrics into the curriculum. The Report also deals with the question of merited recognition for those with special competency or expanded training in geriatrics. Finally, the Report provides support for the Medical Director concept, and looks to the Society's new Section for Long-Term Care Physicians to provide leadership in emphasizing the role of the physician in long-term care. The AGS intends, through future reports, publications, conferences, and liaison relationships with other organizations, to continue this advance, seeking solutions designed to improve and extend the health care of the aging population. PMID:6778906

  19. Comprehensive geriatric assessment of a patient with complex needs.

    PubMed

    Birch, Deborah

    2016-05-01

    This is the third in a short series that presents case study examples of the application of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic assessment model, which is designed to determine a frail older person's medical and mental health status, as well as functional, social and environmental issues. When undertaken by nurses, it can enable individualised care planning. The case study presented explores the application of CGA with an 89-year-old patient with complex health and social care needs. It demonstrates how a hospital admission was avoided and the patient's health outcomes improved, by using a nurse-led systematic approach to assessment and by careful consideration of CGA domains. PMID:27125938

  20. ETHICS IN GERIATRIC MEDICINE RESEARCH

    PubMed Central

    İlgili, Önder; Arda, Berna; Munir, Kerim

    2014-01-01

    This article aims to evaluate the research process in geriatrics from the ethical point of view. The elderly population is increasing rapidly, but there is no parallel in the amount of research concerning this demographic. On the other hand, in the light of research ethics, this group mainly represents vulnerable people and requires more sensitivity. Taking into account all these features, fundamental principles in research ethics are first considered: the soundness of the scientific project, qualifications of the investigators, ethics committee approval, informed consent, confidentiality and privacy, beneficence/nonmaleficence, and justice are evaluated. Special ethical issues in geriatric research such as ageism and research inclusion, paucity of research involving elderly people, vulnerability of elderly subjects, and cognitive impairments are discussed separately. PMID:25489272

  1. Exercise Promotion in Geriatric Oncology.

    PubMed

    Burhenn, Peggy S; Bryant, Ashley Leak; Mustian, Karen M

    2016-09-01

    Evidence of the benefits of exercise for people with cancer from diagnosis through survivorship is growing. However, most cancers occur in older adults and little exercise advice is available for making specific recommendations for older adults with cancer. Individualized exercise prescriptions are safe, feasible, and beneficial for the geriatric oncology population. Oncology providers must be equipped to discuss the short- and long-term benefits of exercise and assist older patients in obtaining appropriate exercise prescriptions. This review provides detailed information about professionals and their roles as it relates to functional assessment, intervention, and evaluation of the geriatric oncology population. This review addresses the importance of functional status assessment and appropriate referrals to other oncology professionals. PMID:27484061

  2. Rhinitis in the geriatric population

    PubMed Central

    2010-01-01

    The current geriatric population in the United States accounts for approximately 12% of the total population and is projected to reach nearly 20% (71.5 million people) by 2030[1]. With this expansion of the number of older adults, physicians will face the common complaint of rhinitis with increasing frequency. Nasal symptoms pose a significant burden on the health of older people and require attention to improve quality of life. Several mechanisms likely underlie the pathogenesis of rhinitis in these patients, including inflammatory conditions and the influence of aging on nasal physiology, with the potential for interaction between the two. Various treatments have been proposed to manage this condition; however, more work is needed to enhance our understanding of the pathophysiology of the various forms of geriatric rhinitis and to develop more effective therapies for this important patient population. PMID:20465792

  3. Geriatric Issues in Older Dialysis Patients.

    PubMed

    Bhattarai, Manoj

    2016-01-01

    Geriatric syndrome is common among older patients on dialysis. Basic knowledge about its prevalence and management is crucial for nephrologists to provide standard patient care. In busy clinical settings, up-to-date and holistic medical care can be delivered to elderly dialysis patients by collaboration of nephrology and geriatrics teams, or in part by training nephrology fellows the basics of geriatrics. [Full article available at http://rimed.org/rimedicaljournal-2016-07.asp, free with no login]. PMID:27379352

  4. Bloodless surgery in geriatric surgery.

    PubMed

    Guarino, Salvatore; Di Matteo, Filippo; Sorrenti, Salvatore; Greco, Roberto; Nardi, Matteo; Favoriti, Pasqualino; De Antoni, Enrico; Filippini, Angelo; Catania, Antonio

    2014-01-01

    In bloodless surgery a series of measures has to be implemented to reduce the perioperative need for transfusion of whole blood or its components. Jehovah's Witness are the most representative group of patients opting for bloodless surgery as their faith follows strict believes that prohibits receiving blood. Geriatric patients requiring bloodless surgery are even more delicate and represent a challenge for surgeons. The physiological response of the over 65 year population to decreased hemoglobin level is slower and less effective than in young and adult patients. Herby we describe the perioperative protocol implemented in our surgical Department offered to geriatric Jehovah's Witness patients. Preoperative optimization of the patients is the key step in the preparation period. Intraoperative anesthetic and surgical measures are also required along with a strict postoperative follow-up. From our experience, bloodless surgery is feasible in the geriatric population as long as it is performed in specialized centers where a multidisciplinary team is prepared to specifically manage this scenario. Rigorous patients selection and preparation are mandatory. PMID:25183638

  5. The Effect of Training on Medical Students' Responses to Geriatric Patient Concerns: Results of a Linguistic Analysis.

    ERIC Educational Resources Information Center

    Robins, Lynne S.; Wolf, Fredric M.

    1989-01-01

    Found that experience-based educational intervention in which medical students interview volunteer nursing home residents significantly changed medical students' responses to two geriatric patient vignettes. Concluded that use of elderly volunteers in practice interviews helped to sensitize students to problems of aging and taught them empathic…

  6. Implications of Research on the Geriatric Voice.

    ERIC Educational Resources Information Center

    Benjamin, Barbaranne J.

    Noting that the progressive aging of the American population has created a need for a body of knowledge about the vocal characteristics associated with aging, this paper provides information on geriatric voice. The first section of the paper contains a selected bibliography of materials concerning geriatric voice, including literature on the need…

  7. Depression in Geriatric and Adult Medical Inpatients.

    ERIC Educational Resources Information Center

    Magni, Guido; And Others

    1985-01-01

    Administered two scales for the evaluation of depression to two groups of medical inpatients: adults (N=201) and geriatric subjects (N=178). Results confirmed a high presence of depressive symptoms among patients with medical problems, particularly among geriatric subjects. Factors most predictive of depressive symptoms are identified. (JAC)

  8. Effective Teaching Methods for Geriatric Competencies

    ERIC Educational Resources Information Center

    Strano-Paul, Lisa

    2011-01-01

    This study assesses how effective classroom sessions are at teaching geriatric competencies to medical students. At Stony Brook Medical School, most geriatric competencies are taught in the Ambulatory Care Clerkship during small-group educational sessions. Clinical exposure to reinforce these specialized skills varies with preceptor assignment. A…

  9. Psychosocial work load and stress in the geriatric care

    PubMed Central

    2010-01-01

    Background Due to the decrease in informal care by family members and the demographic development, the importance of professional geriatric care will rise considerably. Aim of this study was to investigate the psychosocial workplace situation for employees in this profession. Methods The German version of the COPSOQ (Copenhagen Psychosocial Questionnaire) was used for the assessment of psychosocial factors at work. The instrument includes 22 scales and 3 single items concerning demands, control, stress, support, and strain. Results between two study groups of geriatric care were compared to each other as well as to employees in general hospital care and a general population mean (COPSOQ database). Statistical analysis included t-tests, ANOVA and multiple comparisons of means. Statistical significance (p < 0.01, two-tailed) and a difference of at least 5 points in mean values were defined as the relevant threshold. Results In total 889 respondents from 36 institutions took part in the study. 412 worked in Home Care (HC), 313 in Geriatric Nursing Homes (GNH), 164 in other professions (e.g. administration). Comparison between HC and GNH showed more favourable values for the first group for the most scales, e.g. lower quantitative and emotional demands and less work-privacy conflict, better possibilities for development etc. Compared to external values from the German COPSOQ database for general hospital care (N = 1.195) and the total mean across all professions, COPSOQ-total (N = 11.168), the results are again positive for HC workers on most of the scales concerning demands and social support. The only negative finding is the very low amount of social relations at work due to the obligation to work alone most of the time. Employees in GNH rate predictability, quality of leadership and feedback higher when compared to general hospital care and show some further favourable mean values compared to the COPSOQ mean value for all professions. A disadvantage for GNH is the

  10. Neurology of the geriatric patient.

    PubMed

    Fenner, W R

    1988-05-01

    Owing to improvements in health care, more animals are living to advanced ages. Many abnormal neurologic conditions can affect these patients, but those most commonly associated with advancing years include degenerative, neoplastic, and idiopathic processes. An understanding of the "normal" age-related changes seen on a neurologic examination must be kept in mind when evaluating geriatric patients. Special care and consideration of the patient and client are often required in managing these cases, especially because treatment protocols are often unsuccessful or do not exist, resulting in a prognosis that is often poor at best. PMID:3289252

  11. Building Psychosocial Programming in Geriatrics Fellowships: A Consortium Model

    ERIC Educational Resources Information Center

    Adelman, Ronald D.; Ansell, Pamela; Breckman, Risa; Snow, Caitlin E.; Ehrlich, Amy R.; Greene, Michele G.; Greenberg, Debra F.; Raik, Barrie L.; Raymond, Joshua J.; Clabby, John F.; Fields, Suzanne D.; Breznay, Jennifer B.

    2011-01-01

    Geriatric psychosocial problems are prevalent and significantly affect the physical health and overall well-being of older adults. Geriatrics fellows require psychosocial education, and yet to date, geriatrics fellowship programs have not developed a comprehensive geriatric psychosocial curriculum. Fellowship programs in the New York tristate area…

  12. Geriatric simulation: practicing management and leadership in care of the older adult.

    PubMed

    Miller, Sally; Overstreet, Maria

    2015-06-01

    According to the Centers for Disease Control and Prevention, patients age 65 and older account for 43% of hospital days. The complexity of caring for older adults affords nursing students opportunities to assess, prioritize, intervene, advocate, and experience being a member of an interdisciplinary health care team. However, these multifaceted hospital experiences are not consistently available for all students. Nursing clinical simulation (NCS) can augment or replace specific clinical hours and provide clinically relevant experiences to practice management and leadership skills while caring for older adults. This article describes a geriatric management and leadership NCS. PMID:25999076

  13. Potential drug interactions in an ambulatory geriatric population.

    PubMed

    Costa, A J

    1991-09-01

    Drug interactions are a common cause of iatrogenic disease in geriatric patients. Computer programs now exist which allow one to analyse groups of drugs for potential interactions. In an audit of charts of 100 geriatric patients seen in the Family Practice Center at Barberton Citizens Hospital, a computer printout was obtained, listing all patients aged 60 years and over who were seen at the Center during 1989. Names were selected randomly from this list by the head nurse and their charts were obtained for review, generating information on patient identification number, age, sex, diagnoses, medications, and allergies. The medications were analysed using the Hansten Drug Interaction Knowledge Base Program, which identified 27 patients as being on a combination of medications which had one or more potential drug interactions. A total of 37 potential drug interactions were identified in this group of 27 patients. Relative risk ratios were determined using the computer program, 'Epi Info,' for sex (female versus male), age (greater than or equal to 75 vs. 60-75 years), number of diagnoses greater than or equal to 3 vs. 0-2), and number of medications (greater than or equal to 4 vs. 0-3). The five medications, or groups of medications, which were most likely to be involved in potential drug interactions were digoxin, beta-blockers, oestrogen, oral hypoglycaemic agents, and diuretics. PMID:1822974

  14. Poor oral health, a potential new geriatric syndrome.

    PubMed

    van der Putten, Gert-Jan; de Baat, Cees; De Visschere, Luc; Schols, Jos

    2014-02-01

    This article presents a brief introduction to the medical aspects of ageing and age-related diseases, and to some geriatric syndromes, followed by a discussion on their impact on general and oral healthcare provision to community-dwelling older people. Recent investigations suggest that inflammation constitutes a biological foundation of ageing and the onset of age-related diseases. Multimorbidity and polypharmacy, together with alterations in pharmacokinetics and pharmacodynamics, make older people at risk of adverse medication reactions. A side effect of several medications is causing xerostomia and hyposalivation, and both the type and number of medications used are relevant. New options of general healthcare provision to community-dwelling older people are the use of mobility aids and assistive technology devices, domiciliary health care, respite care and telecare. Their oral health status may be jeopardised by frailty, disability, care dependency and limited access to professional oral health care. Recommendations for improvement are the following: better integrating oral health care into general health care, developing and implementing an oral healthcare guideline, providing customised oral hygiene care aids, domiciliary oral healthcare provision, visiting dental hygienists and/or nurses, oral hygiene telecare, easily and safely accessible dental offices, transforming dentistry into medical oral health care and upgrading dentists to oral physicians. In case oral healthcare providers do not take the responsibility of persuading society of the importance of adequate oral health, weakened oral health of community-dwelling older people will become a potential new geriatric syndrome. PMID:24446975

  15. Addressing ethical issues in geriatrics and long-term care: ethics education at the Baycrest Centre for Geriatric Care.

    PubMed

    Gordon, M; Turner, L; Bourret, E

    2000-01-01

    An innovative program in ethics education exists at Baycrest Centre for Geriatric Care. This program can serve as a helpful model for long-term care and geriatric care facilities seeking to implement formal training programs in bioethics. Various aspects of the ethics education program are examined. In addition to describing the role of the ethics committee and research ethics board, consideration is given to case consultations, ethics rounds, the training of junior physicians and medical students, grand rounds and the planning of conferences and guest lectures. With regard to educational content in bioethics, health law, professional guidelines and the principlist approach of Beauchamp and Childress are used to explore the ethical dimensions of particular cases. Given the clinical context of the educational initiatives, the pedagogical approach is predominately case-based. While the bioethics literature emphasizes the patient-physician relationship, ethics education at Baycrest recognizes the importance of multiple professions. Physicians, nurses, social workers, speech pathologists, nutritionists and other health care providers are involved in ethical deliberation and education. PMID:11143884

  16. The Teaching Nursing Home as an Academic Program.

    ERIC Educational Resources Information Center

    Weiler, Philip G.

    1987-01-01

    Reviews the origins of the teaching nursing home concept, describes its goals and major components, and explores some of the problems in developing it as an academic program. Asserts that the teaching nursing home, if properly developed, can be a strong academic program that improves geriatric patient care, research, and teaching. (Author/ABB)

  17. [LIMITATIONS OF THE BIOMEDICAL PARADIGM IN GERIATRICS INSTITUTIONS].

    PubMed

    Robledo, María Laura; Cabello, Cecilia; Dahl, Silvina

    2015-01-01

    The social perception of ageing related to the loss of both physical and psychological functions that determine in many cases the institutionalization of the elderly in nursing homes, leads to a medical care focused on a biomedical model, centered on organic factors as determinants of the illness. Illness is not an isolated condition in an individual, but has a subjective and social dimension. For this reason the biographic history becomes the main reference point in the care of the elderly. People experiment their disease within a narrative that gives a meaning to their experience; but this is not considered by the biomedical model, where the psychosocial factors that influence the onset or progression of the pathology are disregarded. This article attempts to explore the problem that arises when the care of the elderly that reside in geriatric institutions is centered on the biomedical model. PMID:26650415

  18. Hyperthyroidism in the geriatric population.

    PubMed

    Federman, D D

    1991-02-15

    Although the thyroid gland can become overactive at any age, the syndrome of hyperthyroidism changes considerably in elderly persons. The principal reason is comorbidity. The patient over age 65 is much more likely than a young adult of 20 or 25 to have one or more preexisting disorders when the thyroid becomes overactive. In the elderly, therefore, the classic picture of hyperthyroidism--the constellation of irritability, sweating, palpitations without heart disease, weight loss despite good appetite, goiter, and warm, fine skin, familiar to all physicians--may never develop. Well before it might have appeared, a milder degree of thyroid hyperfunction may become manifest because of worsening of an underlying disease. Accordingly, the recognition of the thyroid disorder is often delayed. The purpose of this article is not so much to review hyperthyroidism as to delineate the special features found in geriatric patients and to describe a simple but effective scheme of evaluation. PMID:1899255

  19. Guidelines for Graduate Medical Education in Geriatrics.

    ERIC Educational Resources Information Center

    Robbins, Alan S.; Beck, John C.

    1982-01-01

    Performance objectives, core content, training experiences, and clinical exposure and program evaluations are described for geriatric fellows and house staff members in internal medicine, family practice, neurology, and psychiatry. A modified Delphi study was used. (Author/MLW)

  20. Pharmaceutical services in a capitated geriatric care program.

    PubMed

    Sorrento, T A; Bonanza, K C; Salisbury, D W

    1996-12-01

    A hospital outpatient pharmacy's planning and implementation of pharmaceutical services for a capitated geriatric care program are described. The hospital's director of pharmacy and pharmacy ambulatory care manager proposed providing distributive and clinical services for enrollees in Independent Living for Seniors (ILS), a program designed to help elderly persons to continue living at home instead of in nursing homes. ILS receives pooled monthly payments from Medicare and Medicaid; a copayment is required of enrollees not eligible for Medicaid. Medical and social services are offered, primarily through adult daycare centers. Nurses at the centers monitor ILS enrollees regularly and help them manage their medications. After a year of negotiations with the program, the outpatient satellite of the hospital's inpatient pharmacy began providing services; one pharmacist was assigned to ILS. Problems with medication stock at the daycare centers were corrected. Conservative supplies of stock drugs (mostly nonprescription items) and medications to meet patients' needs between daily pharmacy deliveries were established. A new computerized medication administration record was developed. Once distributive services were in place, a pharmacy and therapeutics committee began establishing a formulary. The pharmacist functions as part of an interdisciplinary care team, providing education on drug use and managing costs; he reviews all patients' charts every four months and meets weekly with ILS staff to recommend changes in drug therapy. The cost of services provided by the hospital outpatient pharmacy averaged $77 per patient per month in the first year, compared with about $120 for the previous vendor. A hospital's ambulatory care pharmacy improved the pharmaceutical services provided to a capitated geriatric care program. PMID:8957345

  1. Positioning Medical Students for the Geriatric Imperative: Using Geriatrics to Effectively Teach Medicine

    ERIC Educational Resources Information Center

    Nguyen, Annie L.; Duthie, Elizabeth A.; Denson, Kathryn M.; Franco, Jose; Duthie, Edmund H.

    2013-01-01

    Medical schools must consider innovative ways to ensure that graduates are prepared to care for the aging population. One way is to offer a geriatrics clerkship as an option for the fulfillment of a medical school's internal medicine rotation requirement. The authors' purpose was to evaluate the geriatrics clerkship's impact on…

  2. An international model for geriatrics program development in China: the Johns Hopkins-Peking Union Medical College experience.

    PubMed

    Leng, Sean X; Tian, Xinping; Liu, Xiaohong; Lazarus, Gerald; Bellantoni, Michele; Greenough, William; Fried, Linda P; Shen, Ti; Durso, Samuel C

    2010-07-01

    China has the world's largest and most rapidly growing older adult population. Recent dramatic socioeconomic changes, including a large number of migrating workers leaving their elderly parents and grandparents behind and the 4:2:1 family structure caused by the one-child policy, have greatly compromised the traditional Chinese family support for older adults. These demographic and socioeconomic factors, the improved living standards, and the quest for higher quality of life are creating human economic pressures. The plight of senior citizens is leading to an unprecedented need for geriatrics expertise in China. To begin to address this need, the Johns Hopkins University School of Medicine (JHU) and Peking Union Medical College (PUMC) have developed a joint international project aimed at establishing a leadership program at the PUMC Hospital that will promote quality geriatrics care, education, and aging research for China. Important components of this initiative include geriatrics competency training for PUMC physicians and nurses in the Division of Geriatric Medicine and Gerontology at JHU, establishing a geriatrics demonstration ward at the PUMC Hospital, faculty exchange between JHU and PUMC, and on-site consultation by JHU geriatrics faculty. This article describes the context and history of this ongoing collaboration and important components, progress, challenges, and future prospects, focusing on the JHU experience. Specific and practical recommendations are made for those who plan such international joint ventures. With such unique experiences, it is hoped that this will serve as a useful model for international geriatrics program development for colleagues in the United States and abroad. PMID:20533962

  3. [Backup territorial coordination, nursing roles and skills].

    PubMed

    Benyahia, Amina; Abraham, Éliane

    2016-06-01

    Backup territorial coordination provides accompaniment and support for professionals who work with the fragile elderly people in an area. It aligns the sanitary, medical-social and social approaches, and mobilizes useful resources to optimize the treatment pathway. It has been implemented in the Nancy urban area by an operational team including nurses and a geriatric physician. PMID:27338688

  4. THE INFLAMMATION HYPOTHESIS IN GERIATRIC DEPRESSION

    PubMed Central

    Alexopoulos, George S.; Morimoto, Sarah Shizuko

    2011-01-01

    Background A large body of research has focused on “mediating mechanisms” and predisposing brain abnormalities to geriatric depression, but little is known about its etiology. This paper examines whether age-related and comorbid disease-related immune deregulation is an etiologic contributor to geriatric depression. Methods This article reviews findings on neuroinflammation during the aging process and depression as well as studies of anti-inflammatory actions of classical antidepressants and antidepressant actions of anti-inflammatory agents. Results Aging results in increased peripheral immune responses, impaired peripheral-CNS immune communication, and a shift of the CNS into a pro-inflammatory state. These exaggerated and prolonged immune responses may lead to changes in the function of emotional and cognitive networks pertinent to geriatric depression and to behavioral changes reminiscent of the depressive and cognitive symptoms of geriatric depression. Some antidepressants may reduce the expression of inflammation markers. Limited data suggest that some anti-inflammatory agents may have antidepressant properties. Conclusions A synthesis of available findings suggests that aging-related and comorbid disease-related inflammatory processes may promote changes in the neural systems predisposing to geriatric depression or facilitating metabolic changes that mediate depressive syndromes. The “inflammation hypothesis” in geriatric depression cannot be tested in its entirety, but it can lead to testable hypotheses and data on mechanisms by which inflammatory processes promote geriatric depression. The significance of such an effort is that it may lead to a novel treatment development model bringing to bear recent advances of anti-inflammatory pharmacology to the treatment of depressed elderly patients. PMID:21370276

  5. Evaluation of geriatric changes in dogs

    PubMed Central

    Pati, Soumyaranjan; Panda, S. K.; Acharya, A. P.; Senapati, S.; Behera, M.; Behera, S. S.

    2015-01-01

    Aim: The present study has been envisaged to ascertain the old age for critical management of geriatric dogs considering the parameters of externally visible changes, haemato-biochemical alterations and urine analysis in geriatric dogs approaching senility. Materials and Methods: The study was undertaken in the Department of Veterinary Pathology in collaboration with Teaching Veterinary Clinic complex spanning a period of 1 year. For screening of geriatric dogs, standard geriatric age chart of different breeds was followed. The external characteristics such as hair coat texture, dental wear and tear, skin texture and glaucoma were taken as a marker of old age. Haematology, serum biochemistry and urine analysis were also included in the study. Results: External visible changes like greying of hair, dull appearance of hair coat, glaucoma, osteoarthritis, dental wear and tear were commonly encountered in the aged dogs. The haemoglobin, total erythrocyte count and packed cell volume showed a decreasing trend in the geriatric groups. Biochemical values like total protein, albumin, calcium level showed a decreasing trend while urea level with an increasing trend in geriatric dogs without any much alteration in serum glutamic-oxaloacetic transaminse, serum glutamic-pyruvate transaminase, cholesterol and creatinine. Physical examination of urine revealed yellow, amber, red, deep red color with turbidity and higher specific gravity. Chemical examination revealed presence of protein, glucose, ketone bodies, blood and bilirubin on some cases. The culture and sensitivity test of the urine samples revealed presence of bacteria with sensitive and resistance to some antibiotics. Conclusion: External visible changes are still the golden standard of determining the old age in dogs. Haemato-biochemical evaluation can be useful for correlating with the pathophysiological status of the animal. Biochemical analysis of urine can be employed rightly as kidney dysfunction is being major

  6. Long Term Outcomes of a Geriatric Liaison Intervention in Frail Elderly Cancer Patients

    PubMed Central

    Hempenius, Liesbeth; Slaets, Joris P. J.; van Asselt, Dieneke; de Bock, Truuske H.; Wiggers, Theo; van Leeuwen, Barbara L.

    2016-01-01

    Background The aim of this study was to evaluate the long term effects after discharge of a hospital-based geriatric liaison intervention to prevent postoperative delirium in frail elderly cancer patients treated with an elective surgical procedure for a solid tumour. In addition, the effect of a postoperative delirium on long term outcomes was examined. Methods A three month follow-up was performed in participants of the Liaison Intervention in Frail Elderly study, a multicentre, prospective, randomized, controlled trial. Patients were randomized to standard treatment or a geriatric liaison intervention. The intervention consisted of a preoperative geriatric consultation, an individual treatment plan targeted at risk factors for delirium and daily visits by a geriatric nurse during the hospital stay. The long term outcomes included: mortality, rehospitalisation, Activities of Daily Living (ADL) functioning, return to the independent pre-operative living situation, use of supportive care, cognitive functioning and health related quality of life. Results Data of 260 patients (intervention n = 127, Control n = 133) were analysed. There were no differences between the intervention group and usual-care group for any of the outcomes three months after discharge. The presence of postoperative delirium was associated with: an increased risk of decline in ADL functioning (OR: 2.65, 95% CI: 1.02–6.88), an increased use of supportive assistance (OR: 2.45, 95% CI: 1.02–5.87) and a decreased chance to return to the independent preoperative living situation (OR: 0.18, 95% CI: 0.07–0.49). Conclusions A hospital-based geriatric liaison intervention for the prevention of postoperative delirium in frail elderly cancer patients undergoing elective surgery for a solid tumour did not improve outcomes 3 months after discharge from hospital. The negative effect of a postoperative delirium on late outcome was confirmed. Trial Registration Nederlands Trial Register, Trial ID NTR 823

  7. [Ambulatory geriatric rehabilitation--concepts, chances and responsibilities of participating physicians].

    PubMed

    Stamm, T; Rittgerodt, K; Gehrke, A

    1995-12-01

    The third stage of the bill of the health structure (GSG) still focuses on the tremendous increase of costs in hospitals. Hospitals are accused that the care of the older patients involves too much money and staff. Experts complain that geriatric-rehabilitative thinking and acting does hardly influence the daily work on the wards. Competent geriatric rehabilitation should diminish or prevent the need for nursing, should support the patients ability for self-sufficiency, and decrease hospitalization time. Since the expenses for the hospital care of older patients have increased during the last couple of years and show the greatest dynamic of increase together with the supply of aids, health politicians and health economists, physicians, health insurances, and social insurances set more and more medical and economic hope on the geriatric rehabilitation. Especially models of out of hospital programs in connection with panel doctors are discussed to relieve the hospitals and are favoured by legal institutions and health politicians. Despite the documented success of geriatric rehabilitation, it is surprising the only a few areas realize differentiated out of hospital concepts. This article summarizes the most important models of out of hospital geriatric rehabilitation as they are tested in different areas in Germany. Advantages and disadvantages are discussed and the demands of the participating physicians are demonstrated. The goal of this paper is to describe the medical role in these models to win more physicians for this task. The urgently necessary development of a country-wide out of hospital rehabilitation, introduces new important medical fields of activity. PMID:8850116

  8. [Imaging update in geriatric oncology].

    PubMed

    Gualdi, G F; Bertini, L; Lanciotti, S; Colaiacomo, M C; Casciani, E; Polettini, E

    2004-09-01

    The cancer is a problem that plagues all the ages but the greater part of the malignant tumors hits the old persons. The more elevated incidence sites of primary tumor in geriatrical age are the prostate, the lung and the colon-rectum in the men and the breast, the colon-rectum, the lung and the stomach in the women. The imaging has made steps of giant in the last few decades, with the introduction of new equipment and methodical news so as to assure everybody early and accurated diagnosis. For the lung carcinoma great advantages have been bring to us with the introduction of CT-PET and the multislice CT, that has concurred the execution of virtual bronchoscopy. The virtual endoscopy has been applied with happening also in the screening of the carcinoma of colon-rectum, executed through CT or MR. New MR technologies have allowed perform spectroscopic studies in such organs as prostate and breast, bringing the biochemical diagnosis beyond that morphologic. The MR then turns out fundamental in the appraisal of the Patient with bone metastases thanks also to the new whole body examinations. Finally the recent technology has allowed the execution of multiorgan CT screening bringing in this way new possibilities but also new questions. PMID:15700630

  9. When Patients Teach Their Doctors: A Curriculum for Geriatric Education

    ERIC Educational Resources Information Center

    Tomkowiak, John; Gunderson, Anne

    2004-01-01

    In response to aging patient demographics and a call for increased formal geriatric training in medical schools, a community volunteer geriatric mentor program, Bridging Generations, was developed to shape attitudes of medical students caring for the elderly. The geriatric mentor experience provided students with unique insight into the challenges…

  10. Undergraduate Teaching in Geriatric Medicine: The Role of National Curricula

    ERIC Educational Resources Information Center

    Blundell, Adrian; Gordon, Adam; Gladman, John; Masud, Tahir

    2009-01-01

    There has been recent international concern that the teaching of geriatrics may be in decline. Research has suggested that support for geriatrics in national undergraduate curricula is the key to effective delivery of teaching in the specialty. We set out to determine the geriatric medicine content in the U.K. generic curriculum, reviewing this in…

  11. Geriatrics Educational Outreach: A Tale of Three GRECCs

    ERIC Educational Resources Information Center

    Clark, Elizabeth; Fitzgerald, James T.; Griffith, Jennifer; Weir, Charlene

    2011-01-01

    Current geriatrics workforce projections indicate that clinicians who care for adults will need basic geriatrics knowledge and skills to address the geriatric syndromes and issues that limit functional independence and complicate medical management. This is most evident for the clinicians caring for veterans in the Department of Veterans Affairs…

  12. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    PubMed Central

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  13. Palliative care in the ambulatory geriatric practice.

    PubMed

    Finucane, Thomas E; Nirmalasari, Olivia; Graham, Antonio

    2015-05-01

    Geriatrics and palliative care often overlap. This article focuses on 2 areas where the disciplines may differ in their approach. The first is planning for extreme illness and death, with explicit acknowledgment that limiting therapy might be a good idea. This situation is likely to have a different impact in the course of a routine geriatrics visit than in a palliative care context. The second is pain management, especially chronic pain. In patients with sharply limited life expectancy, the risk/benefit equation tilts easily toward narcotic use. In frail elders working to remain independent, the calculus may be quite different. PMID:25920055

  14. How the principles of geriatric assessment are shaping managed care.

    PubMed

    Fillit, H M; Hill, J; Picariello, G; Warburton, S

    1998-04-01

    In traditional geriatric medicine, comprehensive assessment is considered crucial to the care of frail older patients. The principles of geriatric assessment--identifying high-risk patients and targeting them for preventive interventions--are also practiced by managed care organizations (MCOs). Self-reported health surveys and administrative data are two methods used by MCOs to identify members at high risk for adverse health outcomes and functional decline who may benefit from geriatric case management. For a successful partnership with primary care physicians, it is very important that geriatric care managers should be knowledgeable in the principles of geriatric medicine. PMID:9559029

  15. One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment

    PubMed Central

    Eschbach, Daphne; Bliemel, Christopher; Oberkircher, Ludwig; Aigner, Rene; Hack, Juliana; Bockmann, Benjamin; Ruchholtz, Steffen; Buecking, Benjamin

    2016-01-01

    Purpose. Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU) treatment, including invasive ventilatory management (IVM) and hemodiafiltration (CVVHDF), is sparse. Methods. Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA) classification, and the Barthel index (BI) were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care. Results. 15% were treated > 3 days and 68% < 3 days in ICU. Both cohorts had similar ASA, BI, and age. In-hospital, 6-month, and 12-month mortality of ICU > 3d cohort were significantly increased (p = 0.001). Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort. PMID:26881228

  16. One-Year Outcome of Geriatric Hip-Fracture Patients following Prolonged ICU Treatment.

    PubMed

    Eschbach, Daphne; Bliemel, Christopher; Oberkircher, Ludwig; Aigner, Rene; Hack, Juliana; Bockmann, Benjamin; Ruchholtz, Steffen; Buecking, Benjamin

    2016-01-01

    Purpose. Incidence of geriatric fractures is increasing. Knowledge of outcome data for hip-fracture patients undergoing intensive-care unit (ICU) treatment, including invasive ventilatory management (IVM) and hemodiafiltration (CVVHDF), is sparse. Methods. Single-center prospective observational study including 402 geriatric hip-fracture patients. Age, gender, the American Society of Anesthesiologists (ASA) classification, and the Barthel index (BI) were documented. Underlying reasons for prolonged ICU stay were registered, as well as assessed procedures like IVM and CVVHDF. Outcome parameters were in-hospital, 6-month, and 1-year mortality and need for nursing care. Results. 15% were treated > 3 days and 68% < 3 days in ICU. Both cohorts had similar ASA, BI, and age. In-hospital, 6-month, and 12-month mortality of ICU > 3d cohort were significantly increased (p = 0.001). Most frequent indications were cardiocirculatory pathology followed by respiratory failure, renal impairment, and infection. 18% of patients needed CVVHDF and 41% IVM. In these cohorts, 6-month mortality ranged > 80% and 12-month mortality > 90%. 100% needed nursing care after 6 and 12 months. Conclusions. ICU treatment > 3 days showed considerable difference in mortality and nursing care needed after 6 and 12 months. Particularly, patients requiring CVVHDF or IVM had disastrous long-term results. Our study may add one further element in complex decision making serving this vulnerable patient cohort. PMID:26881228

  17. Geriatric Syndromes: Clinical, Research and Policy Implications of a Core Geriatric Concept

    PubMed Central

    Inouye, Sharon K.; Studenski, Stephanie; Tinetti, Mary E.; Kuchel, George A.

    2008-01-01

    Geriatricians have embraced the term “geriatric syndrome”, using it extensively to highlight the unique features of common health conditions in the elderly. Geriatric syndromes, such as delirium, falls, incontinence and frailty, are highly prevalent, multifactorial, and associated with substantial morbidity and poor outcomes. Nevertheless, this central geriatric concept has remained poorly defined. This article reviews criteria for defining geriatric syndromes, and proposes a balanced approach of developing preliminary criteria based on peer-reviewed evidence. Based on a review of the literature, four shared risk factors—older age, baseline cognitive impairment, baseline functional impairment, and impaired mobility—were identified across five common geriatric syndromes (pressure ulcers, incontinence, falls, functional decline, and delirium). Understanding basic mechanisms involved in geriatric syndromes will be critical to advancing research and developing targeted therapeutic options. However, given the complexity of these multifactorial conditions, attempts to define relevant mechanisms will need to incorporate more complex models, including a focus on synergistic interactions between different risk factors. Finally, major barriers have been identified in translating research advances, such as preventive strategies of proven effectiveness for delirium and falls, into clinical practice and policy initiatives. National strategic initiatives are required to overcome barriers and to achieve clinical, research, and policy advances that will improve quality of life for older persons. PMID:17493201

  18. Comprehensive Geriatric Assessment in the Office

    PubMed Central

    Pereles, Laurie R.M.; Boyle, Neil G.H.

    1991-01-01

    Because of their increased incidence of illness and disability, geriatric patients require extra time and diligence to assess and track medical problems. This article describes a comprehensive geriatirc assessment, organized on a one-page, easily updated checklist, that can be used to generate a medical and functional problem list and a risk assessment. Imagesp2190-a PMID:21229091

  19. Geriatric dentistry--meet the need.

    PubMed

    Issrani, Rakhi; Ammanagi, Renuka; Keluskar, Vaishali

    2012-06-01

    Geriatric dentistry or gerodontics is the delivery of dental care to older adults involving the diagnosis, prevention, and treatment of problems associated with normal ageing and age-related diseases as part of an inter-disciplinary team with other health care professionals. Geriatric health is an ignored and under-explored area worldwide. Oral health reflects overall well being for the elderly population. Conversely, elderly patients are more predisposed to oral conditions due to age-related systemic diseases and functional changes. The major barriers to practising geriatric dentistry are the lack of trained faculty members, a crowded curriculum and monetary concerns. For successful treatment, the practitioner must adopt a humanitarian approach and develop a better understanding of the feelings and attitudes of the elderly. Prevention and early intervention strategies must be formulated to reduce the risk of oral diseases in this population. In future, dental professionals must have a proper understanding of the magnitude of the services to be provided to the elderly. This could only be realised through an education programme in geriatric dentistry, which should be started without further delay. This article hence sets out the objectives, needs, present scenario, strategies and types of dental treatment required by the elderly population. PMID:22612827

  20. [The problems and outlook of geriatric pharmacology].

    PubMed

    Zapadniuk, V I

    1990-01-01

    The analysis of the molecular mechanisms underlying age-related changes in manifestations of pharmacokinetics, pharmacodynamics, therapeutic and toxic properties of drugs in the elderly is presented. The ways of their correction are discussed. The advances in the development of geriatric drugs (dekamevit, kvadevit, ampevit, orkomin, potassium glutaminate, rikavit, trimethylglycine) and the perspectives for the creation of new geroprotectors are described. PMID:2201563

  1. [The particular characteristics of caregivers in geriatrics].

    PubMed

    Viana, Nicola

    2012-01-01

    The perception of the work of a caregiver in geriatrics is often inaccurate. Considered to consist of the most unrewarding tasks, the role of caregivers in supporting residents and families is however essential, both in terms of day-today care as well as for the prevention of dependency. PMID:22741315

  2. Progress in Geriatrics: A Clinical Care Update.

    ERIC Educational Resources Information Center

    Blanchette, Patricia Lanoie; And Others

    1997-01-01

    This issue includes 18 theme articles that examine clinical care, conditions, and practice as they relate to older adults. It contains articles on the following: men's and women's health, depression, dementia, hypertension, incontinence, bone pain, infections, preventive medicine, geriatric medicine, health care delivery, managed care, long-term…

  3. Geriatric Staff Training for Patient Independence.

    ERIC Educational Resources Information Center

    Hickey, Tom

    The project investigated the effectiveness of an evironmental therapy training program for geriatric mental health workers when used in two different institutional settings. Site A was a State-operated facility for psychiatric in-patient care, accommodating 2,000 patients, with emphasis on maintenance and general patient welfare. Site B, a former…

  4. Faculty Preparedness in Geriatric Optometry Education.

    ERIC Educational Resources Information Center

    Mancil, Gary L.; And Others

    1995-01-01

    A survey of chief academic officers and faculty (n=27) in 16 schools of optometry found that, since 1986, there has been a 75% increase in institutions requiring coursework in geriatric optometry and an 83% increase in those offering continuing professional education in this field. However, 67% of faculty report no formal training. Three faculty…

  5. A Health Belief Interview for Clinical Geriatrics.

    ERIC Educational Resources Information Center

    Rakowski, William; Dengiz, Alan N.

    1984-01-01

    Describes a brief nine-item interview, designed for use by practitioners. Based upon results from field-testing with 65 ambulatory geriatric patients, the instrument can be used as an aid to assess health and treatment perceptions in clinical settings. Responses to specific items may also suggest broader areas for follow-up discussion. (JAC)

  6. Interdisciplinary educational approaches to promote team-based geriatrics and palliative care.

    PubMed

    Howe, Judith L; Witt Sherman, Deborah

    2006-01-01

    Despite the increasing public demand for enhanced care of older patients and those with life-threatening illness, health professionals have had limited formal education in geriatrics and palliative care. Furthermore, formal education in interdisciplinary team training is limited. In order to remedy this situation, proactive interventions are being undertaken so that education and training in palliative care is being embedded within the training of physicians, nurses, social workers, as well as other associated health team members. This article discusses various educational approaches to interdisciplinary team-based geriatric and palliative care, highlighting the interdisciplinary didactic and clinical educational opportunities offered by an Interprofessional Palliative Care Fellowship Program, as well as an Associated Health Training Program at the Geriatrics Research, Education, and Clinical Center, Bronx Veteran's Medical Center. The article further describes the educational initiatives in palliative care offered through the Veteran's Integrated Service Network (VISN). Innovative educational strategies are discussed within the context of the existing literature on interdisciplinary health care team training. PMID:16446268

  7. Factors Influencing RNs' Perceptions of Quality Geriatric Care in Rural Hospitals.

    PubMed

    Cline, Daniel D; Dickson, Victoria Vaughan; Kovner, Christine; Boltz, Marie; Kolanowski, Ann; Capezuti, Elizabeth

    2014-07-01

    The rapidly aging population and their frequent use of hospital services will create substantial quality challenges in the near future. Redesigning rural hospital work environments is the key to improving the quality of care for older adults. This study explored how the work environment influences registered nurses' (RNs') perceived quality of geriatric care in rural hospitals. We used an exploratory mixed-methods research design emphasizing the qualitative data (in-depth, semi-structured interviews). Quantitative data (questionnaire) measuring the RN work environment were also collected to augment qualitative data. Four themes emerged: (a) collegial RN relationships, (b) poor staffing/utilization, (c) technology benefits/challenges, and (d) RN-physician interactions, which were identified as key factors influencing the quality of geriatric care. We concluded that rural hospital work environments may not be optimized to facilitate the delivery of quality geriatric care. Targeted interventions are needed to improve overall quality of care for hospitalized older adults in rural settings. PMID:24319004

  8. [Guideline for integrated geriatric assessment].

    PubMed

    Reyes-Morales, Hortensia; Doubova, Svetlana Vladislavovna; García-González, José Juan; Espinosa-Aguilar, Amilcar; Jiménez-Uribe, Rodrigo; Peña-Valdovinos, Abel; Mendoza-Núñez, Víctor Manuel

    2009-01-01

    A clinical practice guideline was developed as a response to the increasing of elderly in Mexican population due to the epidemiological transition; this instrument allows the assessment of health conditions for people from 60 years of age and older, and it can be a tool for helping family physicians and nurses in providing care for the main health problems of this group of age. The guideline for gerontologic assessment includes six principal health priorities in older people (loss of vision, difficulty to hear, falls or problems walking, nutritional disorders, memory difficulties, and sleep disorders); additionally, another four components for assessment are revised (medication use, physical functionality, quality of life, and social support). Simple recommendations for detection, diagnosis and management of these problems in primary care settings are presented. PMID:20141660

  9. [Review in geriatric medicine 2013].

    PubMed

    Büla, Christophe

    2014-01-15

    Physical activity appears once again as the single most effective preventative intervention in older persons to delaying functional decline, avoiding falls, and mitigating the odds of developing dementia. Integrated care that promotes interdisciplinary collaboration among healthcare professionals is a major avenue to improve care coordination in polymorbid older patients. A study depicts the large gap between physicians and nurses' views about their respective skills and role in such a collaboration. On the cognitive side, while several studies show that new cohorts of older persons appear to age in better cognitive shape, results of trials of semagestat, a gamma-secretase inhibitor, and post-menopausal estrogenic therapy were disappointing. Finally, a study challenges the benefits of hydration in terminally ill patients. PMID:24558897

  10. Care of the Older Adult in the Emergency Department: Nurses Views of the Pressing Issues

    ERIC Educational Resources Information Center

    Boltz, Marie; Parke, Belinda; Shuluk, Joseph; Capezuti, Elizabeth; Galvin, James E.

    2013-01-01

    Purpose: The purpose of the study was to describe nurses' views of the issues to be addressed to improve care of the older adult in the emergency department (ED). Design and Methods: An exploratory content analysis examined the qualitative responses of 527 registered nurses from 49U.S. hospitals who completed the Geriatric Institutional Profile.…

  11. A Statewide Faculty Development Program for Community College Associate Degree and Other Nursing Educators. Final Report.

    ERIC Educational Resources Information Center

    Roush, Robert E.; And Others

    This final report describes a Texas educational improvement project designed to: (1) increase the amount of geriatric content in the curricula of community college associate degree nursing (ADN) programs; (2) further the development of baccalaureate nursing faculty in a Historically Black College/University (HBCU); and (3) facilitate other Texas…

  12. Stimulating Healthy Aging with a Model Nurse-Managed Free Clinic in a Senior Center.

    ERIC Educational Resources Information Center

    Franklin, Ruth H.

    As part of a Geriatric Education and Health Management program, a model nurse-managed free clinic has been established at an urban senior center by faculty and students of the University of New Mexico College of Nursing. Funded by a 3-year grant from the Department of Health and Human Services, the weekly clinic is based on Orem's self-care theory…

  13. Rethinking Teaching Nursing Homes: Potential for Improving Long-Term Care

    ERIC Educational Resources Information Center

    Mezey, Mathy D.; Mitty, Ethel L.; Burger, Sarah Green

    2008-01-01

    To meet the special needs of and provide quality health care to nursing home residents, the health care workforce must be knowledgeable about the aging process. Health professionals are minimally prepared in their academic programs to care for older adults, and few programs have required rotations in geriatrics. Teaching nursing homes (TNHs) have…

  14. International Society of Geriatric Oncology Consensus on Geriatric Assessment in Older Patients With Cancer

    PubMed Central

    Wildiers, Hans; Heeren, Pieter; Puts, Martine; Topinkova, Eva; Janssen-Heijnen, Maryska L.G.; Extermann, Martine; Falandry, Claire; Artz, Andrew; Brain, Etienne; Colloca, Giuseppe; Flamaing, Johan; Karnakis, Theodora; Kenis, Cindy; Audisio, Riccardo A.; Mohile, Supriya; Repetto, Lazzaro; Van Leeuwen, Barbara; Milisen, Koen; Hurria, Arti

    2014-01-01

    Purpose To update the International Society of Geriatric Oncology (SIOG) 2005 recommendations on geriatric assessment (GA) in older patients with cancer. Methods SIOG composed a panel with expertise in geriatric oncology to develop consensus statements after literature review of key evidence on the following topics: rationale for performing GA; findings from a GA performed in geriatric oncology patients; ability of GA to predict oncology treatment–related complications; association between GA findings and overall survival (OS); impact of GA findings on oncology treatment decisions; composition of a GA, including domains and tools; and methods for implementing GA in clinical care. Results GA can be valuable in oncology practice for following reasons: detection of impairment not identified in routine history or physical examination, ability to predict severe treatment-related toxicity, ability to predict OS in a variety of tumors and treatment settings, and ability to influence treatment choice and intensity. The panel recommended that the following domains be evaluated in a GA: functional status, comorbidity, cognition, mental health status, fatigue, social status and support, nutrition, and presence of geriatric syndromes. Although several combinations of tools and various models are available for implementation of GA in oncology practice, the expert panel could not endorse one over another. Conclusion There is mounting data regarding the utility of GA in oncology practice; however, additional research is needed to continue to strengthen the evidence base. PMID:25071125

  15. Leadership development in geriatric care through the Intergeneration Make a Difference Project.

    PubMed

    Kirkpatrick, Mary K; Brown, Sylvia T

    2006-01-01

    The Intergeneration Make a Difference Project (MADP) is designed to develop leadership skills in geriatric nursing for seniors in a baccalaureate nursing program. This service-learning project with octogenarians and older individuals is based on theoretical constructs of caring. Stories and journaling are of great importance in the project. Expected outcomes are cognitive, affective, personal, and interpersonal. Students are expected to engage in critical/reflective thinking and develop leadership skills, heightened respect for the elderly, and interest in lifelong learning and a service orientation to society. Empowered to influence their clients, students receive the reciprocal benefits of an intergenerational relationship that, it is hoped, will affect how they care for the elderly in the future. PMID:16733972

  16. Delirium in the elderly: current problems with increasing geriatric age

    PubMed Central

    Kukreja, Deepti; Günther, Ulf; Popp, Julius

    2015-01-01

    Delirium is an acute disorder of attention and cognition seen relatively commonly in people aged 65 yr or older. The prevalence is estimated to be between 11 and 42 per cent for elderly patients on medical wards. The prevalence is also high in nursing homes and long term care (LTC) facilities. The consequences of delirium could be significant such as an increase in mortality in the hospital, long-term cognitive decline, loss of autonomy and increased risk to be institutionalized. Despite being a common condition, it remains under-recognised, poorly understood and not adequately managed. Advanced age and dementia are the most important risk factors. Pain, dehydration, infections, stroke and metabolic disturbances, and surgery are the most common triggering factors. Delirium is preventable in a large proportion of cases and therefore, it is also important from a public health perspective for interventions to reduce further complications and the substantial costs associated with these. Since the aetiology is, in most cases, multfactorial, it is important to consider a multi-component approach to management, both pharmacological and non-pharmacological. Detection and treatment of triggering causes must have high priority in case of delirium. The aim of this review is to highlight the importance of delirium in the elderly population, given the increasing numbers of ageing people as well as increasing geriatric age. PMID:26831414

  17. Hemangiosarcoma in a geriatric Labrador retriever.

    PubMed

    Sharma, Diya

    2012-08-01

    A geriatric Labrador retriever dog was presented for acute collapse. The dog was conscious but lethargic, tachypneic, tachycardic with weak femoral pulses, occasional pulse deficits, and pale mucous membranes. Radiography, ultrasonography, quick assessment tests, and a complete blood (cell) count (CBC)/biochemistry panel indicated internal hemorrhage and potential problems with hemostasis. The dog was euthanized. A necropsy, histopathology, and immunohistochemistry for CD31 and Factor VIII-related antigen cell markers supported a diagnosis of splenic hemangiosarcoma. PMID:23372199

  18. Redefining the Economics of Geriatric Orthopedics

    PubMed Central

    Nacca, Christopher; Paller, David; Daniels, Alan H

    2014-01-01

    Introduction: The heath care system in the United States is in the midst of a transition, in large part to help accommodate an older and more medically complex population. Central to the current evolution is the reassessment of value based on the cost utility of a particular procedure compared to alternatives. The existing contribution of geriatric orthopedics to the societal burden of disease is substantial, and literature focusing on the economic value of treating elderly populations with musculoskeletal injuries is growing. Materials and Methods: A literature review of peer-reviewed publications and abstracts related to the cost-effectiveness of treating geriatric patients with orthopedic injuries was carried out. Results: In our review, we demonstrate that while cost-utility studies generally demonstrate net society savings for most orthopedic procedures, geriatric populations often contribute to negative net society savings due to decreased working years and lower salaries while in the workforce. However, the incremental cost-effective ratio for operative intervention has been shown to be below the financial willingness to treat threshold for common procedures including joint replacement surgery of the knee (ICER US$8551), hip (ICER US$17 115), and shoulder (CE US$957) as well as for spinal procedures and repair of torn rotator cuffs (ICER US$12 024). We also discuss the current trends directed toward improving institutional value and highlight important complementary next steps to help overcome the growing demands of an older, more active society. Conclusion: The geriatric population places a significant burden on the health care system. However, studies have shown that treating this demographic for orthopedic-related injuries is cost effective and profitable for providers under certain scenarios. PMID:26246943

  19. [Why should Byzantium be considered as a cradle of clinical geriatrics?].

    PubMed

    Lapin, Alexander

    2008-01-01

    Generally, roots of today's medical ethics are thought to have sprouted from antiquity and from classical Hebraic consciousness, while the origin of hospital medicine and institutional nursing of the elderly was assumed in Middle Age and in modern times, respectively. But even between these two periods, notably in Byzantium (324-1453) there were many famous physicians working with surprising skills in many disciplines such as surgery and ophthalmology. The most important achievement of that time, however, was in public health care. Following the Christian ideal of philanthropy, numerous hospitals (nosokomeia), hospices (xenodocheia) and asylums for the elderly (gerokomeia) of a remarkable organisation and professionalism were founded in many cities of the Byzantine Empire. Concerning the elderly patients, interesting findings were obtained concerning ageing process (eschatogeria), geriatric symptoms, multimorbidity, marasm and typically occurring diseases. Interesting approaches were realized with regard to the nursing care, diet and recommended life style for the elderly. By the end of the Byzantium Empire in 1453 and due to the different cultural development in the West, which was sometimes marked by conflicts between church and science and by the regulations of medicine, the knowledge about the Byzantine health care was almost lost. It survived, however, only in hospitals of occidental monastic orders, which brought their experience from East-Mediterranean area. Their hospitals were than a base for modern health care and for geriatrics. PMID:18807237

  20. Everyday Excellence: A Framework for Professional Nursing Practice in Long-Term Care

    PubMed Central

    Lyons, Stacie Salsbury; Specht, Janet Pringle; Karlman, Susan E.

    2009-01-01

    Registered nurses make measurable contributions to the health and wellness of persons living in nursing homes. However, most nursing homes do not employ adequate numbers of professional nurses with specialized training in the nursing care of older adults to positively impact resident outcomes. As a result, many people never receive excellent geriatric nursing while living in a long-term care facility. Nurses have introduced various professional practice models into health care institutions as tools for leading nursing practice, improving client outcomes, and achieving organizational goals. Problematically, few professional practice models have been implemented in nursing homes. This article introduces an evidence-based framework for professional nursing practice in long-term care. The Everyday Excellence framework is based upon eight guiding principles: Valuing, Envisioning, Peopling, Securing, Learning, Empowering, Leading, and Advancing Excellence. Future research will evaluate the usefulness of this framework for professional nursing practice. PMID:20077966

  1. Geriatric Patients With Fractures Below the Hip are Medically Similar to Geriatric Patients With Hip Fracture

    PubMed Central

    Uppal, Harmeeth S.; Copeland, Marilyn E.; Crist, Brett D.; Volgas, David A.

    2015-01-01

    The objective of this study was to compare a cohort of geriatric patients with operatively managed isolated fractures below the hip to a cohort of geriatric patients with operatively managed isolated hip fractures. All patients greater than 59 years of age admitted to our institution for surgical care of an isolated lower extremity fracture during a 3-year period were included. Patients were divided into 2 cohorts: BTH (fracture below the subtrochanteric region of the femur) and HIP (proximal femoral fracture at subtrochanteric region or proximal). We identified 141 patients included in cohort BTH and 205 patients included in cohort HIP. HIP patients were older (P < .01) and less obese (P < .01) but were otherwise very similar. An extensive comorbidity review revealed that the 2 cohorts were similar, with the exception of an increased incidence of dementia (P = .012) or glaucoma (P = .04) in HIP patients and of peripheral neuropathy (P = .014) in BTH patients. HIP patients were more likely to be under active antiosteoporotic medication management and were more likely to be receiving pharmacological anticoagulation at the time of admission. HIP patients and BTH patients were similar with regard to necessity of assistance with ambulation preinjury, but HIP patients were less likely to reside independently at home than were BTH patients (P < .001). HIP patients were also less likely to be discharged directly home from the hospital (P < .001). Geriatric patients with fractures below the hip are medically similar to geriatric patients with hip fracture. Medical comanagement protocols have been extensively published that improve care of geriatric patients with hip fracture; consideration should be given to similar protocol-driven medical comanagement programs for geriatric patients with fractures below the hip. PMID:26246950

  2. Geriatric Telemedicine: Background and Evidence for Telemedicine as a Way to Address the Challenges of Geriatrics

    PubMed Central

    2015-01-01

    Objectives The global population of elderly people is increasing at a remarkable rate, which may be expected to continue for some time. Older patients require more care, and with the current model of care delivery, the costs may be expected to rise, although higher cost is unsustainable. For this reason, a new pattern of practice is needed. Telemedicine will be presented as a highly effective and necessary tool in geriatrics. Methods This review will present some of the background and evidence for telemedicine as a way to address the challenges of geriatrics through geriatric telemedicine. Some of the evidence for the value of telemedicine as a tool for physicians and healthcare systems is presented. Results Telemedicine offers many means to address the problems of geriatric care in creative ways. The use of electronic medicine, telecommunications, and information management has now found its way into the very fabric of health care. The use of telemedicine is a fait accompli in much of the world, and it continues to have an increasing role deeply imbedded in our electronic practices coupled with social media. Conclusions The evidence for successful incorporation of telemedicine into practice is abundant and continues to accrue. This is a great opportunity for medical practice to evolve to new levels of engagement with patients and new levels of attainment in terms of quality care. PMID:26618027

  3. Effectiveness of three types of geriatric medical services: lessons for geriatric psychiatric services.

    PubMed Central

    Cole, M G

    1991-01-01

    OBJECTIVES: To determine the effectiveness of geriatric medical services, to identify the types of patients who would benefit from such services, to determine the service components related to positive outcomes and to apply pertinent findings to geriatric psychiatric services. DATA SOURCES: Two databases, MEDLINE and Health Planning and Administration, were searched for relevant articles published from January 1975 to February 1990. The bibliographies of identified articles were searched for additional references. STUDY SELECTION: Seventeen reports were located that met the following three inclusion criteria: original research, published in English or French and controlled trial (nonrandomized or randomized) of a geriatric medical service. Fifteen met the validity criteria for intervention studies established by McMaster University, Hamilton, Ont. DATA EXTRACTION: Information about study design, patient selection, interventions, outcome measures and results was systematically abstracted from each report. DATA SYNTHESIS: Abstracted data were compared and contrasted. Most of the external services and some of the hospital units were effective in reducing the number of hospital days an deaths. Consultation services were ineffective. Continuing care appeared to be related to positive outcomes. CONCLUSION: In applying these findings to geriatric psychiatric services priority should be given to the development of external services and the organization of continuing care. PMID:2025818

  4. The need for geriatric dental education in India: the geriatric health challenges of the millennium.

    PubMed

    Thomas, Susan

    2013-06-01

    The rapid growth in the elderly population in a developing country such as India poses social and financial challenges by causing a shift towards non-communicable diseases and increases in chronic diseases. The economic impact of the burden of chronic diseases such as cardiovascular disease, hypertension, diabetes and cancer are high. The link between oral health and general health are particularly pronounced in older populations and impairs their quality of life. This paper reveals that in order to address the increasing health challenges and demands of a growing geriatric population, undergraduates and graduate students in dental schools should be given comprehensive or holistic health assessment training. Cost-effective modern educational strategies and educational tools such as problem-based learning will help to overcome the dearth of trained faculty in geriatric dentistry. Multidisciplinary health-care approaches and extended health-care team work are of vital importance to older patients who could benefit physically and psychologically from more efficient dental treatment. With often more than one chronic disease affecting individuals and use of polypharmacy, there is a need to increase overall knowledge of geriatric pharmacy and geriatric medicine. Measures to help older people remain healthy and active are a necessity in developing countries such as India for effective social and economic development. PMID:23691957

  5. Development of an Interview-Based Geriatric Depression Rating Scale.

    ERIC Educational Resources Information Center

    Jamison, Christine; Scogin, Forrest

    1992-01-01

    Developed interview-based Geriatric Depression Rating Scale (GDRS) and administered 35-item GDRS to 68 older adults with range of affective disturbance. Found scale to have internal consistency and split-half reliability comparable to those of Hamilton Rating Scale for Depression and Geriatric Depression Scale. Concurrent validity, construct…

  6. Designing a Multi-Disciplinary Geriatrics Health Professional Mentoring Program

    ERIC Educational Resources Information Center

    Cotter, J. James; Coogle, Constance L.; Parham, Iris A.; Head, Colleen; Fulton, LaQuana; Watson, Kathleen; Curtis, Angela

    2004-01-01

    This paper describes a Geriatric Health Professionals Mentoring Program designed to address recruitment and retention of health professionals in geriatrics and gerontology. The training provided information on the mentoring process, negotiating mentoring agreements, and coaching mentees. The evaluative framework described examines: (a) the effects…

  7. Elder Specialists: Psychosocial Aspects of Medical Education in Geriatric Care

    ERIC Educational Resources Information Center

    McCann-Stone, Nancy; Robinson, Sherry B.; Rull, Gary; Rosher, Richard B.

    2009-01-01

    This paper describes an Elder Specialist Program developed by one school of medicine to sensitize medical students to geriatric psychosocial issues. Elder Specialists participate in panel discussions as part of each geriatric session. As an alternative to traditional senior mentoring programs, the Elder Specialist Program provides all students a…

  8. Dental Students' Self-Assessed Competence in Geriatric Dentistry.

    ERIC Educational Resources Information Center

    Kiyak, H. Asuman; Brudvik, James

    1992-01-01

    A study of four classes of dental students (n=172) exposed to both didactic and clinical geriatric dental training found that the students perceived significant improvements in their abilities to manage geriatric patients in all areas assessed, notably treatment planning, preventive dentistry, referrals, and providing care in alternative settings.…

  9. Pharmacists' Perceptions of Major Difficulties in Geriatric Pharmacy Practice.

    ERIC Educational Resources Information Center

    Pratt, Clara Collette; And Others

    1982-01-01

    Pharmacists (N=233) responded to the question "What is the most difficult aspect of geriatric pharmacy practice?" Most commonly cited problems were (1) inadequate professional skills or knowledge in geriatrics; (2) patient compliance; (3) physician functioning (including overprescribing of medications); (4) communication with the elderly; (5) lack…

  10. Factor Analytic Composition of the Geriatric Rating Scale (GRS)

    ERIC Educational Resources Information Center

    Smith, James M.; And Others

    1977-01-01

    Ambulatory geriatric patients (N=370) were rated on the Geriatric Rating Scale and results factor analyzed. The scale was found to be composed of three factors: Withdrawal/Apathy, Antisocial Disruptive Behavior, and Deficits in Activities of Daily Living. The results help explain some of the findings regarding sex differences in previous research.…

  11. Behavioral Ratings of Health Professionals' Interactions with the Geriatric Patient.

    ERIC Educational Resources Information Center

    Adelson, R.; And Others

    1982-01-01

    Reports the reliability and validity of the Health Professional-Geriatric Patient Interaction Behavior Rating Code, an observational instrument that is used to quantify the interpersonal behaviors of health professionals in the care of the geriatric patient. Condensed 15 behavioral factors into 10 operationally defined behavioral categories.…

  12. Medical Student Attitudes toward Geriatric Medicine and Patients.

    ERIC Educational Resources Information Center

    Perrotta, Peter; And Others

    1981-01-01

    The influence of factual knowledge about the aged, general attitudes toward the aged, and personal contact with the aged on first-year medical students' attitudes toward geriatric patients and geriatric medicine was examined. Entering medical students indicated a preference for working with younger patients rather than aged patients. (Author/MLW)

  13. Teaching the Multidisciplinary Team Approach in a Geriatrics Miniresidency.

    ERIC Educational Resources Information Center

    Jackson, J. Edward; And Others

    1990-01-01

    A description is provided of the miniresidency program in geriatrics at the University of California, San Diego, School of Medicine which focuses on the multidisciplinary approach to the care of geriatric patients. Observations are given as to the program's effectiveness. (GLR)

  14. Financing geriatric programs in community health centers.

    PubMed Central

    Yeatts, D E; Ray, S; List, N; Duggar, B

    1991-01-01

    There are approximately 600 Community and Migrant Health Centers (C/MHCs) providing preventive and primary health care services principally to medically underserved rural and urban areas across the United States. The need to develop geriatric programs within C/MHCs is clear. Less clear is how and under what circumstances a comprehensive geriatric program can be adequately financed. The Health Resources and Services Administration of the Public Health Service contracted with La Jolla Management Corporation and Duke University Center on Aging to identify successful techniques for obtaining funding by examining 10 "good practice" C/MHC geriatric programs. The results from this study indicated that effective techniques included using a variety of funding sources, maintaining accurate cost-per-user information, developing a marketing strategy and user incentives, collaborating with the area agency on aging and other community organizations, and developing special services for the elderly. Developing cost-per-user information allowed for identifying appropriate "drawing card" services, negotiating sound reimbursement rates and contracts with other providers, and assessing the financial impact of changing service mixes. A marketing strategy was used to enhance the ability of the centers to provide a comprehensive package of services. Collaboration with the area agency on aging and other community organizations and volunteers in the aging network was found to help establish referral networks and subsequently increase the number of elderly patients served. Finally, development of special services for the elderly, such as adult day care, case management, and health education, was found to increase program visibility, opportunities to work with the network of services for the aging, and clinical utilization. PMID:1908588

  15. Person-Environment Interactions Contributing to Nursing Home Resident Falls

    PubMed Central

    Hill, Elizabeth E.; Nguyen, Tam H.; Shaha, Maya; Wenzel, Jennifer A.; DeForge, Bruce R.; Spellbring, Ann Marie

    2011-01-01

    Although approximately 50% of nursing home residents fall annually, the surrounding circumstances remain inadequately understood. This study explored nursing staff perspectives of person, environment, and interactive circumstances surrounding nursing home falls. Focus groups were conducted at two nursing homes in the mid-Atlantic region with the highest and lowest fall rates among corporate facilities. Two focus groups were conducted per facility: one with licensed nurses and one with geriatric nursing assistants. Thematic and content analysis revealed three themes and 11 categories. Three categories under the Person theme were Change in Residents’ Health Status, Decline in Residents’ Abilities, and Residents’ Behaviors and Personality Characteristics. There were five Nursing Home Environment categories: Design Safety, Limited Space, Obstacles, Equipment Misuse and Malfunction, and Staff and Organization of Care. Three Interactions Leading to Falls categories were identified: Reasons for Falls, Time of Falls, and High-Risk Activities. Findings highlight interactions between person and environment factors as significant contributors to resident falls. PMID:20077985

  16. The Use of the Internet in Geriatrics Education: Results of a National Survey of Medical Geriatrics Academic Programs

    ERIC Educational Resources Information Center

    Hajjar, Ihab M.; Ruiz, Jorge G.; Teasdale, Thomas A.; Mintzer, Michael J.

    2007-01-01

    In order to characterize use of the Internet in medical geriatrics education programs, 130 medical education programs in the U.S. that train medical students, interns, residents, fellows and practicing physicians were asked to complete a survey developed by the Consortium of E-Learning in Geriatrics Instruction (CELGI). Sixty-eight programs…

  17. Abdominal Pain in the Geriatric Patient.

    PubMed

    Leuthauser, Amy; McVane, Benjamin

    2016-05-01

    Abdominal pain in the elderly can be a challenging and difficult condition to diagnose and treat. The geriatric population has significant comorbidities and often takes polypharmacy that can mask symptoms. The presentation of common conditions can be different than that in the younger population, often lacking the traditional indicators of disease, making it of pivotal importance for the clinician to consider a wide differential during their workup. It is also important to consider extra-abdominal abnormality that may manifest as abdominal pain. PMID:27133249

  18. Geriatric care in a provincial hospital.

    PubMed

    De V Meiring, P

    1977-03-26

    Much of the work of the public medical wards at Grey's Hospital is concerned with the care of aged persons. In the absence of separate geriatric facilities, this work forms an integral part of internal medicine. During the last decade two surveys, and experience gained, have determined a comprehensive approach to the social and medical problems encountered. While team work can accomplish much, the responsibility for care of the aged currently remains divided among a number of government and private agencies. Without a unified policy and further expenditure of a certain amount of money, many of our senior citizens will continue to be denied easy access to health care facilities. PMID:857323

  19. Delta Alerts: Changing Outcomes in Geriatric Trauma.

    PubMed

    Wiles, Lynn L; Day, Mark D; Harris, LeAnna

    2016-01-01

    Geriatric trauma patients (GTPs) suffering minor injuries have suboptimal outcomes compared with younger populations. Patients 65 years or older account for 10% of all traumas but 28% of all trauma deaths. This trauma center established a third tier trauma alert specifically targeting GTPs at risk for poor outcomes. A Delta Alert is activated when GTPs suffer injuries that fall outside traditional trauma alert guidelines. Early identification and treatment of injuries and expedited referral to specialty groups have improved our GTPs' outcomes including decreased mortality and length of stay and increased percentage of GTPs who are discharged home. PMID:27414140

  20. Thyroid disorders in the geriatric veterinary patient.

    PubMed

    Scott-Moncrieff, J Catharine

    2012-07-01

    The effects of age, concurrent illness, and administered medications complicate diagnosis of thyroid dysfunction in geriatric patients. Interpretation of thyroid hormone testing should take these factors into account. The most common thyroid disorder in dogs is acquired hypothyroidism. Therapeutic monitoring should be utilized for monitoring treatment of canine hypothyroidism. The most common thyroid disorder in cats is benign hyperthyroidism. Diagnosis is most often complicated by the presence of concurrent illness. Treatment should be individualized based on individual case characteristics and presence of concurrent illness. Some older cats have a palpable goiter months to years before development of clinical signs of hyperthyroidism. PMID:22720810

  1. Geriatric psycho-social history outline.

    PubMed

    Velardo, C C

    1976-10-01

    The details of a Geriatric Psycho-Social History Outline for use with the institutional aged are presented. All health care facilities require background information on the patient at the time of admission, but with long-term facilities a more comprehensive psycho-social history is needed. The Outline provides a basis for obtaining information in five categories: 1) identification (detailed, observational and attitudinal); 2) referral source; 3) background; 4) family constellation or environmental factors; and 5) finances. Its comprehensiveness requires more than one pre-admission interview. It is aimed at reducing morbidity and mortality rates following admission to long-term facilities. If the aged person becomes somewhat familiar with the institution before admission, he is less susceptible to accelerated physiologic and psycho-social deterioration and death. Because of constant growth in the field of gerontology, new and improved instruments must be devised to help carry the load. The Geriatric Psycho-Social History Outline is for use as a guide to those who require such information if they are to function at maximum efficiency. PMID:965679

  2. Why do geriatric patients visit otorhinolaryngology?

    PubMed

    Özler, Gül Soylu; Yengil, Erhan

    2016-06-01

    The number and proportion of people more than 65 years old in the population are increasing with the rise in life expectancy. This study was designed to investigate the otolarygologic needs and visits of geriatric patients. We conducted a retrospective study that included all patients ≥65 years of age who visited the otolaryngology department between 8 a.m. and 4 p.m. during 1 year. Age, gender, main complaint, and clinical diagnosis were noted on a chart and analyzed. In 2012, a total of 19,875 patients attended the otolaryngology department between 8 a.m. and 4 p.m., of whom 418 (2.1%) were aged ≥65 years. The most common complaints were ear and hearing disorders (24.2%), epistaxis(15.3%), balance disorders (15.1%), pharyngotonsillar pathologies (14.8%), and head and facial trauma (9.6%). This study shows that the changing patient population will change the type and frequencies of pathologies seen in general otolaryngology practices. Geriatric patients need a targeted approach to their diseases because they have special issues unique to their population. PMID:27304440

  3. [Clinical practice guideline: a complete geriatric evaluation].

    PubMed

    Medina-Chávez, Juan Humberto; Torres-Arreola, Laura Del Pilar; Cortés-González, Rosa María; Durán-Gómez, Verónica; Martínez-Hernández, Fernando; Esquivel-Romero, Gustavo

    2011-01-01

    The care of elderly patients requires an evaluation that deserves a host of special considerations, such as biological aspects of aging, those related to activities of daily living and functionality, neuro-psychological conceptions, family dynamics and economic conditions. The growth of the aging population in our country is accompanied by an increase in chronic diseases and more individuals have greater vulnerability, requiring a more consumption of resources because of the high demand for services. This requires the incorporation of specialized care in the institutional system, which has caused serious consequences in the current health system, benefiting specialization and technology, but with a loss of an integrated and horizontal view of the patient. Therefore it is necessary to develop a practical tool that allows the family physician to identify and differentiate the geriatric population that requires specialized care from who does not, identifying problems that may improve and allow the design of strategies to improve health status and maintain functional autonomy of the elderly. Comprehensive Geriatric Assessment (CGA) is a fundamental tool for clinical practice of any medical care to the elderly. PMID:22176832

  4. Nursing Supplies

    MedlinePlus

    ... Stages Listen Español Text Size Email Print Share Nursing Supplies Page Content Article Body Throughout most of ... budget. (Nursing equipment also makes wonderful baby gifts.) Nursing Bras A well-made nursing bra that comfortably ...

  5. Telemedicine for Specialist Geriatric Care in Small Rural Hospitals: Preliminary Data.

    PubMed

    Gray, Leonard C; Fatehi, Farhad; Martin-Khan, Melinda; Peel, Nancye M; Smith, Anthony C

    2016-06-01

    Small rural hospitals admit and manage older adults who, in city hospitals, would usually be offered geriatrician-supported comprehensive geriatric assessment and coordinated subacute care if required. Distance and diseconomies of scale prohibit access to the conventional in-person approach. A telegeriatric service model involving a geriatrician consulting remotely using wireless, mobile, high-definition videoconferencing; a trained host nurse at the rural site; structured geriatric assessment configured on a web-based clinical decision support system; routine weekly virtual rounds; and support from a local multidisciplinary team was established to overcome these barriers. This was a prospective observational study to examine the feasibility and sustainability of the model. Patient characteristics were recorded using the interRAI Acute Care assessment system. Usage patterns were derived from health service data sets and a service statistics database. Patients had characteristics that are consistent with characteristics of individuals typically referred for geriatric assessment. Overall, 53% of patients had cognitive impairment, 75% had limitations with activities of daily living, and the average Frailty Index was 0.44 ± 0.12. Stable patterns of consultation occurred within 6 months of start-up and continued uninterrupted for the remainder of the 24-month observation period. The estimated overall rate of initial consultation was 1.83 cases per occupied bed per year and 2.66 review cases per occupied bed per year. The findings indicate that the model was feasible and was sustained throughout and beyond the study period. This telegeriatric service model appears suitable for use in small rural hospitals. PMID:27321617

  6. Geriatric Syndromes in Older HIV-Infected Adults

    PubMed Central

    Greene, Meredith; Covinsky, Kenneth E.; Valcour, Victor; Miao, Yinghui; Madamba, Joy; Lampiris, Harry; Cenzer, Irena Stijacic; Martin, Jeffrey; Deeks, Steven G.

    2015-01-01

    Background Geriatric syndromes such as falls, frailty, and functional impairment are multifactorial conditions used to identify vulnerable older adults. Limited data exists on these conditions in older HIV-infected adults and no studies have comprehensively examined these conditions. Methods Geriatric syndromes including falls, urinary incontinence, functional impairment, frailty, sensory impairment, depression and cognitive impairment were measured in a cross-sectional study of HIV-infected adults age 50 and older who had an undetectable viral load on antiretroviral therapy (ART). We examined both HIV and non-HIV related predictors of geriatric syndromes including sociodemographics, number of co-morbidities and non-antiretroviral medications, and HIV specific variables in multivariate analyses. Results We studied 155 participants with a median age of 57 (IQR 54-62); (94%) were men. Pre-frailty (56%), difficulty with instrumental activities of daily living (46%), and cognitive impairment (47%) were the most frequent geriatric syndromes. Lower CD4 nadir (IRR 1.16, 95% CI 1.06-1.26), non-white race (IRR 1.38, 95% CI 1.10-1.74), and increasing number of comorbidities (IRR 1.09, 95%CI 1.03-1.15) were associated with increased risk of having more geriatric syndromes. Conclusions Geriatric syndromes are common in older HIV infected adults. Treatment of comorbidities and early initiation of ART may help to prevent development of these age related complications. Clinical care of older HIV-infected adults should consider incorporation of geriatric principles. PMID:26009828

  7. The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

    PubMed

    Carlson, Elisabeth; Bengtsson, Mariette

    2014-04-01

    The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. PMID:23954003

  8. Nursing: What's a Nurse Practitioner?

    MedlinePlus

    ... nurses, or APNs) have a master's degree in nursing (MS or MSN) and board certification in their ... Nurse Practitioners (NAPNAP) and through local hospitals or nursing schools. In addition, many doctors share office space ...

  9. Contemporary Systemic Therapy for Urologic Malignancies in Geriatric Patients.

    PubMed

    Zhao, Bo; Grivas, Petros D

    2015-11-01

    Current data on systemic therapy in geriatric populations with genitourinary malignancies are largely derived from retrospective analyses of prospectively conducted trials or retrospective reviews. Although extrapolation of these data to real-world patients should be cautious, patients aged 65 years or older with good functional status and minimal comorbidities seem to enjoy similar survival benefit from therapy as their younger counterparts. Chronologic age alone should generally not be used to guide management decisions. Comprehensive geriatric assessment tools and prospective studies in older adults integrating comprehensive geriatric assessment can shed light on the optimal management of urologic malignancies in this population. PMID:26476122

  10. The effect of chlorhexidine in reducing oral colonisation in geriatric patients: a randomised controlled trial

    PubMed Central

    Sharif-Abdullah, Sharifah Shafinaz Binti; Chong, Mei Chan; Surindar-Kaur, Surat Singh; Kamaruzzaman, Shahrul Bahyah; Ng, Kwan Hoong

    2016-01-01

    INTRODUCTION Inadequate oral care has been implicated in the development of aspiration pneumonia in frail geriatric patients and is a major cause of mortality, due to the colonisation of microbes in vulnerable patients. This type of pneumonia has been associated with an increase in respiratory pathogens in the oral cavity. The aim of this study was to evaluate the effects of chlorhexidine compared to routine oral care in edentulous geriatric inpatients. METHODS A double-blind, parallel-group randomised controlled trial was carried out. The intervention group received oral care with chlorhexidine 0.2%, while the control group received routine oral care with thymol. Nurses provided oral care with assigned solutions of 20 mL once daily over seven days. Oral cavity assessment using the Brief Oral Health Status Examination form was performed before each oral care procedure. Data on medication received and the subsequent development of aspiration pneumonia was recorded. An oral swab was performed on Day 7 to obtain specimens to test for colonisation. RESULTS The final sample consisted of 35 (control) and 43 (intervention) patients. Chlorhexidine was effective in reducing oral colonisation compared to routine oral care with thymol (p < 0.001). The risk of oral bacterial colonisation was nearly three times higher in the thymol group compared to the chlorhexidine group. CONCLUSION The use of chlorhexidine 0.2% significantly reduced oral colonisation and is recommended as an easier and more cost-effective alternative for oral hygiene. PMID:27211885

  11. Homocysteine and disability in hospitalized geriatric patients.

    PubMed

    Marengoni, Alessandra; Cossi, Stefania; De Martinis, Monica; Calabrese, Paolo A; Orini, Stefania; Grassi, Vittorio

    2004-08-01

    Elevated total homocysteine (tHcy) concentrations have been found to be associated with cardiovascular disease and dementia in old age. The present study was performed to identify the prevalence of hyperhomocysteinemia (HHcy) and to analyze the association between tHcy concentration and sociodemographic characteristics, nutritional parameters, and cognitive and functional status in this sample of hospitalized geriatric patients. A total of 214 patients (77% females) 65+ years old admitted into an acute care geriatric ward of an internal medical department in the Northern Italy were studied. tHcy concentration was measured using a high-performance liquid chromatography with fluorescence detection (HPLC-F). Information about nutrition (body mass index [BMI], serum albumin, cholesterol, and transferrin) was collected on admission. Functional status was investigated with the Basic Activities of Daily Living scale (ADL) and the Instrumental Activities of Daily Living scale (IADL); cognitive and affective status were assessed by the Mini-Mental State Evaluation (MMSE) and the Geriatric Depression Scale (GDS). The mean tHcy concentration was 18.4 +/- 13.1 micromol/L; 74.2% of males and 68.9% of females had HHcy (> 12 micromol/L). Sixty-four percent of patients with normal serum vitamin B12 and folate concentrations had HHcy. Elevated tHcy concentrations were associated with older age, male gender, increasing serum creatinine, lower MMSE score, and disability. The mean tHcy concentration depended on the occurrence of different diseases. Patients affected by atherosclerotic diseases, such as ischemic heart diseases, cerebrovascular diseases, and dementia had higher mean tHcy concentration than those without diagnosed vascular diseases. In multivariate analysis, vitamin B12, folate, serum albumin, creatinine, and disability emerged as factors associated with tHcy, adjusted for age, gender, education, MMSE score, and atherosclerotic diseases. Our results suggest that the

  12. [Nursing development at the Solothurn hospitals. Towards clinically oriented nursing expertise and practice development].

    PubMed

    Schäfer, Ursi Barandun; Hirsbrunner, Therese; Jäger, Susanne; Näf, Ernst; Römmich, Sabine; Horlacher, Kathrin

    2011-02-01

    At the Solothurn Hospitals (soH), 13 academically educated nurses are responsible for the development of nursing care with the goal to improve patient-oriented, effective, appropriate, and economic care. The strategy contains three priorities: a) expert care of single patients in demanding situations, b) sustained application of organisational methods such as primary nursing, nursing process, and skill/grade mix, and c) design and management of practice development projects related to specific patient groups. A first evaluation with qualitative and quantitative methods showed that the exemplary care of single patients by expert nurses was evaluated as positive for the patients as well as for the teams on two wards by nurses who were interviewed. After the introduction of primary nursing, the application rate was 81 to 90 % and the introduction of fall prevention methods in geriatric rehabilitation decreased the fall rate from 8.2 to 5.5 per 1000 patient days. A comparision with the literature shows that the expert nurses of soH perform both, working at the bedside and being responsible for practice development projects, as specialised Advanced Practice Nurses (APNs). APNs at the Solothurn Hospitals work also as generalists when organisational methods need to be consolidated. Their successes depend from their integration into the hierarchy and both, into the nursing as well as into the interprofessional teams. Competencies in Transformational Leadership also are essential at all management levels. PMID:21274841

  13. Comprehensive geriatric assessment of a mental health service user with safeguarding needs.

    PubMed

    North, Chris

    2016-05-27

    This is the final article in a short series that presents case study examples of the use of comprehensive geriatric assessment (CGA) in different clinical settings. CGA is a holistic model that is used to determine frail older people's medical and mental health status, as well as any functional, social and environmental issues that might affect their care. When undertaken by nurses, it can enable individualised planning for health, safety and wellbeing. This article explores the case of an older woman living in the community who was receiving support from a number of health and social care services and who had significant safeguarding needs. It highlights the complexity of caring for patients with physical and mental health conditions. CGA can link these conditions and needs together to allow a better understanding of their effects on the patient. The risks of significant transitions in care are also highlighted, along with recommendations for the provision of multidisciplinary care in community settings. PMID:27231083

  14. The Geriatric Day Hospital: A Canadian Experience

    PubMed Central

    Wolochow, Michael; Ham, Richard J.

    1986-01-01

    As geriatric day hospitals (GDHs) and assessment units (GAUs) become increasingly established as part of the Canadian medical scene, a closer definition is emerging both of the role of the family physician working in their programs and also of the role of the family physician whose patient is being assessed in their units. This paper briefly summarizes the development of GDHs and GAUs in Canada, their rationale and their objectives. A detailed account is given of such a functioning program, the Short Term Assessment and Treatment (STAT) Centre at Vancouver General Hospital. The relationships of the family physician working there as a team member are described, and the role of the community family physician whose patient is being assessed in such a program is clarified. PMID:20469452

  15. Interprofessional meetings in geriatric assessment units: a matter of care organization.

    PubMed

    Leclerc, Bernard-Simon; Presse, Nancy; Bolduc, Aline; Dutilleul, Aurore; Couturier, Yves; Kergoat, Marie-Jeanne

    2013-11-01

    Inpatient geriatric assessment units (GAUs) exist in Quebec, Canada, to deliver comprehensive, integrated care to older vulnerable patients. Most cases should be discussed at interprofessional meetings (IMs), but research has shown this not to be so for 39% of GAU patients. Consequently, a study was undertaken to (1) describe GAU team composition and (2) identify GAU and patient characteristics associated with case discussion at IMs at least once during a patient's stay. To this end, 877 hospitalization records from 44 GAUs were reviewed. Results showed most teams were composed of attending physicians, nurses, physical and occupational therapists, dietitians and social workers; 66% included clinical pharmacists and 43% liaison nurses. Multilevel modeling showed longer length of stay to be the strongest predictor of case discussion at an IM. Case discussion was also more likely for patients admitted via in- or inter-hospital transfer rather than via the emergency department, if the GAU included a liaison nurse, and if the GAU was not located in an urban area. In summary, case discussion at an IM depended more on how and where a patient was admitted than on the patient characteristics per se, suggesting that this is a matter of care organization. PMID:23802732

  16. Geriatric syndromes in patients with chronic kidney disease.

    PubMed

    Gołębiowski, Tomasz; Augustyniak-Bartosik, Hanna; Weyde, Wacław; Klinger, Marian

    2016-01-01

    The recent epidemiologic data pointed out, that the general number of patients on hemodialysis is steadily increasing, especially in group of elderly patients over 75 years old. The geriatric syndromes are a multietiological disorder related to physiological aging and partly associated with comorbid conditions. Frailty, falls, functional decline and disability, cognitive impairment and depression are main geriatric syndromes and occurs in patients with impaired renal function more often than among general population. The causes of higher prevalence of those syndromes are not well known, but uremic environment and overall renal replacement therapy may have an important impact on its progress. The patient with geriatric syndrome require comprehensive treatment as well as physical rehabilitation, psychiatric cure and support in everyday activities. Herein below we would like to review recent literature regarding to particular features of main geriatric syndromes in a group of nephrological patients. PMID:27333928

  17. Geriatric consultation services-are wards more effective than teams?

    PubMed

    Cameron, Ian D; Kurrle, Susan

    2013-01-01

    Geriatric consultation teams are one of the models for bringing comprehensive geriatric assessment to vulnerable and frail older people in the acute care hospital setting. While ward-based comprehensive geriatric assessment has been established as effective with reference to improving functional status and other outcomes, the team-based variant remains unproven for outcomes other than mortality in the medium term, as shown in a recent study published in BMC Medicine by Deschodt and colleagues. Further research might establish the effectiveness of the team-based model but, for current clinical practice, the emphasis should be on streaming older people with complex problems needing multidisciplinary assessment and treatment to ward-based models of comprehensive geriatric assessment. PMID:23433506

  18. Curricular Strategies for Geriatrics Education in a Medical School.

    ERIC Educational Resources Information Center

    Reyes-Ortiz, Carlos A.; Moreno-Macias, Carlos H.

    2001-01-01

    Discusses the following: barriers to geriatrics education, teaching strategies (such as communication with patients, acceptance of one's own aging, interdisciplinary teamwork), and curriculum design for undergraduate and graduate study. (Contains 26 references.) (SK)

  19. Electroconvulsive Therapy in the Elderly: New Findings in Geriatric Depression.

    PubMed

    Geduldig, Emma T; Kellner, Charles H

    2016-04-01

    This paper reviews recent research on the use of electroconvulsive therapy (ECT) in elderly depressed patients. The PubMed database was searched for literature published within the past 4 years, using the search terms: "electroconvulsive elderly," "electroconvulsive geriatric," "ECT and elderly," and "ECT elderly cognition." The studies in this review indicate excellent efficacy for ECT in geriatric patients. Adverse cognitive effects of ECT in this population are usually transient and not typically severe. In addition, continuation/maintenance ECT (C/M-ECT) may be a favorable strategy for relapse prevention in the elderly after a successful acute course of ECT. ECT is an important treatment option for depressed geriatric patients with severe and/or treatment-resistant illness. New data add to the evidence demonstrating that ECT is a highly effective, safe, and well-tolerated antidepressant treatment option for geriatric patients. PMID:26909702

  20. Humanities and Geriatric Education: a Strategy for Recruitment?

    PubMed Central

    Frank, Christopher; Martin, Ruth Elwood

    2015-01-01

    Ageing is a common subject in arts and literature as it is a universal experience. The use of the humanities in medical education may have a positive effect on trainees’ attitude to caring for seniors and on geriatrics as a career choice. This paper summarizes the role of humanities in medical education and provides some examples and thoughts on how humanities curriculum can be used in geriatric teaching. PMID:25825611

  1. Review of efficacy and safety of laxatives use in geriatrics

    PubMed Central

    Izzy, Manhal; Malieckal, Anju; Little, Erin; Anand, Sury

    2016-01-01

    AIM: To study the efficacy and safety of pharmacological treatment of constipation in geriatrics. METHODS: PubMed, MEDLINE, google scholar, and Ovid were searched to identify human studies performed on the use of laxatives in elderly with constipation, which were conducted between January 1990 and January 2013 using the specified keywords. Controlled studies that enrolled geriatric patients with a diagnosis of constipation and addressed the efficacy and/or the safety of pharmacological treatments were included. Studies were excluded from this review if they were non-controlled trials, case series, or case reports. RESULTS: Out of twenty three studies we initially retrieved in our search, only nine studies met the eligibility criteria of being controlled trials within geriatrics. The laxatives examined in the nine studies were senna, lactulose, sorbital, polyethylene glycol (PEG), lubiprostone, linaclotide, and prucalopride. In those studies, senna combinations had a higher efficacy than sorbitol or lactulose as well as, a very good adverse effect profile. PEG was also shown to be safe and effective in geriatric population. Furthermore, it has been shown that PEG is as safe in geriatrics as in general population. New agents like lubiprostone and prucalopride show promising results but the data about these agents in geriatrics are still limited which warrants further investigation. CONCLUSION: Senna combinations and PEG appear to have a more favorable profile over the other traditionally used laxatives in elderly patients with constipation. PMID:27158549

  2. The ELDER Project: educational model and three-year outcomes of a community-based geriatric education initiative.

    PubMed

    Lange, Jean W; Mager, Diana; Greiner, Philip A; Saracino, Katherine

    2011-01-01

    The purpose of the ELDER (Expanded Learning and Dedication to Elders in the Region) Project was to address the needs of underserved older adults by providing worksite education to individuals who provide nursing care to older adults in community health centers, home health agencies, and long-term care facilities. Four agencies located in a Health Professional Shortage and Medically Underserved Area participated. Project staff conducted separate focus groups with administrators and staff at each agency to determine educational needs and preferences. Curricula from the Hartford Institute, End-of-Life Nursing Education Consortium, and Geriatric Education Centers were adapted to design unique curricula for each agency and level of personnel (licensed nurse or unlicensed caregiver). Activities included focus group meetings to tailor content to the needs of each agency, on-site educational sessions, and identification of an agency champion to sustain the program after the funding ended. A case-based simulation-learning approach was used in the final year to validate application of knowledge and to facilitate teamwork and interprofessional communication. Over 100 nurses and nursing assistants and eight administrators and allied health professionals participated over the three-year period of the project. Retention over this period, independent evaluations, and simulations demonstrated participants' ability to integrate best practices into typical clinical scenarios and revealed improved communication among care providers. Tailored on-site education incorporating simulation was an effective model for translating gerontological knowledge into practice and improving the care of older adults in these multiple settings. PMID:21598149

  3. Nursing, Nursing Education, and Anxiety.

    ERIC Educational Resources Information Center

    Biggers, Thompson; And Others

    In response to the current crisis in the field of nursing, a study examined nursing students' perceived work-related stress and differences among associate degree, diploma, and baccalaureate nursing programs in their preparation of nursing students. The 171 subjects, representing the three different nursing programs, completed a questionnaire…

  4. Nursing Homes

    MedlinePlus

    ... our e-newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed ... physical health and/or mental disabilities. Is a Nursing Home Right for You? Almost half of all ...

  5. Nursing Positions

    MedlinePlus

    ... Story" 5 Things to Know About Zika & Pregnancy Nursing Positions KidsHealth > For Parents > Nursing Positions Print A ... and actually needs to feed. Getting Comfortable With Breastfeeding Nursing can be one of the most challenging ...

  6. The Relative Value Unit in academic geriatrics: incentive or impediment?

    PubMed

    Resnick, Neil M; Radulovich, Nichole

    2014-03-01

    Although the number of older adults is rapidly expanding, the number of healthcare professionals trained in geriatrics is small and declining. The reasons are multifaceted, but because responsibility for training such professionals resides largely in academic health centers (AHCs), their support for geriatrics is critical. As AHCs face increasing financial pressure, many are seeking metrics to measure productivity and the Relative Value Unit (RVU) may be the one most commonly selected. Yet little is known about the RVU's effect on geriatric programs. Review of the literature and a survey of the leaders of the Association of Directors of Geriatric Academic Programs suggest that the advantages of an RVU-based metric are likely eclipsed by its negative impact on the care of older adults, the ability of academic geriatrics to accomplish its mission, and even the survival of geriatrics. If the RVU is to continue to be used as the index of productivity, it should be modified--by reweighting its codes (or by adding new ones)--and complemented by interventions to ensure patient access, care quality, and efficiency. Because an alternative metric, such as a Patient-based Value Unit may be preferable, this article describes the principles on which one might be based. Regardless, urgent action is required by all stakeholders to address this issue. Without it, the future of academic geriatrics--and with it the innovative care models, research, and training the nation needs to improve care and bend the cost curve--will be difficult if not impossible to sustain. PMID:24512218

  7. A Survey of Geriatrics Courses in North American Chiropractic Programs

    PubMed Central

    Borggren, Cara L.; Osterbauer, Paul J.; Wiles, Michael R.

    2009-01-01

    Purpose: There has been a growing interest in meeting the health care needs of the anticipated “age wave.” In order to prepare for the current demographic trends, we sought to describe the status of geriatrics curricula in the 18 North American English-speaking chiropractic colleges by reviewing geriatric course syllabi. Methods: A cross-sectional survey was conducted using syllabi and catalog information solicited from each English-speaking chiropractic college in North America, collected from January 1, 2007 through June 30, 2007. Information was then summarized. Results: As of June 30, 2007, roughly 78% of colleges submitted their current geriatrics course syllabi. The remaining 4 colleges were estimated using online course catalog information. Sixty-one percent of colleges offered a course that was solely dedicated to the topic of geriatrics. Additionally, 37.5% of syllabi indicating credit load offer 4 or more credits to the course containing the geriatrics component. Also, 31.3% of courses include non-classroom clinical experience, while 50% require an independent study project that provides further geriatrics experience. Furthermore, 41.2% of reported courses classify the teaching strategies as lecture only. Conclusions: These results warrant a proposal for improved curricula in this specialty population. It is proposed that more time be dedicated for this topic, more experiential learning be required, and more clinical focus be given on the needs of this population. A restructure of curricula will provide more clinical experiences for students to better equip future doctors of chiropractic for the increase in geriatric health care needs. PMID:19390680

  8. Spirituality in Nursing: Filipino Elderly's Concept of, Distance from, and Involvement with God

    ERIC Educational Resources Information Center

    de Guzman, Allan B.; Dalay, Naihra Jae Z.; De Guzman, Anthony Joe M.; de Jesus, Luigi Lauren E.; de Mesa, Jacqueline Barbara C.; Flores, Jan Derick D.

    2009-01-01

    Spirituality is an aspect of holistic care delivery by health team members. However, despite the established relationship of spirituality and health, there had been little evidence of ways of assessing spirituality for nurses' clinical practice in Asia, particularly in regard to geriatric patients. This study aimed to establish an eiditic…

  9. Patient Care Assisting. A Curriculum for Career Entry in the Nursing Homes of Georgia.

    ERIC Educational Resources Information Center

    Crawford, Sharon; Bailey, Nancy

    This curriculum guide contains 16 units aimed at training entry-level workers as patient care assistants in nursing homes. The units cover the following topics: the role of patient care assistants; psychosocial needs of geriatric patients; work ethics; legal issues; communication skills; infection control; safety issues; patient hygiene; patient…

  10. Training the Primary Care Internist to Provide Care in Skilled Nursing Facilities.

    ERIC Educational Resources Information Center

    Robbins, John A.

    1983-01-01

    A pilot program at the University of California, Davis, that incorporated skilled nursing facility training into the required curriculum of their primary care internal medicine residency is described. The goal was to increase the residents' knowledge in the care of geriatric patients. (MLW)

  11. Geriatric Nutrition Workshop for the Dietetic Assistant.

    ERIC Educational Resources Information Center

    Oklahoma State Dept. of Vocational and Technical Education, Stillwater. Curriculum and Instructional Materials Center.

    This workshop guide is a unit of study for teaching dietetic assistants to work with elderly persons. The objective of the unit is to enable the students to apply knowledge of the physiological and psychological effects of aging in providing nutritional care to the elderly in independent living and nursing home situations. Following the unit…

  12. Risk scores and geriatric profile: can they really help us in anticoagulation decision making among older patients suffering from atrial fibrillation?

    PubMed Central

    Maes, Frédéric; Dalleur, Olivia; Henrard, Séverine; Wouters, Dominique; Scavée, Christophe; Spinewine, Anne; Boland, Benoit

    2014-01-01

    Objectives Anticoagulation for the prevention of cardio-embolism is most frequently indicated but largely underused in frail older patients with atrial fibrillation (AF). This study aimed at identifying characteristics associated with anticoagulation underuse. Methods A cross-sectional study of consecutive geriatric patients aged ≥75 years, with AF and clear anticoagulation indication (CHADS2 [Congestive heart failure, Hypertension, Age >75, Diabetes mellitus, and prior Stroke or transient ischemic attack] ≥2) upon hospital admission. All patients benefited from a comprehensive geriatric assessment. Their risks of stroke and bleeding were predicted using CHADS2 and HEMORR2HAGES (Hepatic or renal disease, Ethanol abuse, Malignancy, Older (age >75 years), Reduced platelet count or function, Rebleed risk, Hypertension (uncontrolled), Anemia, Genetic factors, Excessive fall risk, and Stroke) scores, respectively. Results Anticoagulation underuse was observed in 384 (50%) of 773 geriatric patients with AF (median age 85 years; female 57%, cognitive disorder 33%, nursing home 20%). No geriatric characteristic was found to be associated with anticoagulation underuse. Conversely, anticoagulation underuse was markedly increased in the patients treated with aspirin (odds ratio [OR] [95% confidence interval]: 5.3 [3.8; 7.5]). Other independent predictors of anticoagulation underuse were ethanol abuse (OR: 4.0 [1.4; 13.3]) and age ≥90 years (OR: 2.0 [1.2; 3.4]). Anticoagulation underuse was not inferior in patients with a lower bleeding risk and/or a higher stroke risk and underuse was surprisingly not inferior either in the AF patients who had previously had a stroke. Conclusion Half of this geriatric population did not receive any anticoagulation despite a clear indication, regardless of their individual bleeding or stroke risks. Aspirin use is the main characteristic associated with anticoagulation underuse. PMID:25053883

  13. Research ethics issues in geriatric psychiatry.

    PubMed

    Dunn, Laura B; Misra, Sahana

    2009-06-01

    Progress in geriatric psychiatric research may be impeded by lack of attention to collecting evidence relevant to ethical issues. As has been noted for some time, unless proactive work is done to identify, clarify, and remediate ethical challenges (see Table 2 for research directions), deleterious effects on research can result, including research bans, unduly overprotective stances, or inaccurate weighing of risks and benefits of research by review boards. With regard to proxy consent, a number of issues require further study. These include: how state laws address (or fail to address) research involving cognitively impaired individuals and what effects this has on research conduct; how IRBs define and weigh risks and benefits in considering research involving proxy consent; how various stakeholders, including the general public, people with disorders that may impair decision-making capacity, and proxies themselves view proxy consent for research; and to what degree proxies' research decisions reflect what patients themselves would decide. The use of advanced directives as a stand alone method for future consent is fraught with difficulties around adequate informed consent for a particular study; however, future study may clarify if such directives provide surrogates with improved understanding of their relative's overall views of the research enterprise and possibly the types of studies they would be willing to participate in even if they are no longer able to provide their own consent. In depression and suicide research, further work is needed to develop standard procedures for meeting the ethical demands of research while conducting rigorous, crucial research. PMID:19486821

  14. Ash Split Cath in geriatric dialyzed patients.

    PubMed

    Conz, P A; Catalano, C; Rizzioli, E; Normanno, M; Fabbian, F; Preciso, G

    2001-09-01

    Vascular access is the essential step in performing hemodialysis in uremic patients. In the absence of a permanent and utilizable native arterio-venous fistula, the use of a tunnelled catheter makes dialysis therapy possible. The Ash Split Cath, a recently introduced chronic hemodialysis catheter, was inserted in five patients (7.1% of our prevalent dialysis population) because of repeated venous thrombosis in three patients and a poor venous tree in two. The mean age of patients was 78 years +/- 7. The average blood flow rate was 250+/-50 ml/minute and the mean venous pressure 140mm Hg +/- 35. Recirculation determined by low flux technique was less than 2%. KT/V calculated 3 months after the catheter placement was 1.2+/-0.02. During the follow-up we did not document any infection of the exit site or related to the catheter. This device is simple to place, gives adequate dialysis treatment and is useful in geriatric dialyzed patients in whom the arterio-venous fistula can no longer be used. PMID:11693424

  15. Altered Synchronizations among Neural Networks in Geriatric Depression

    PubMed Central

    Wang, Lihong; Chou, Ying-Hui; Potter, Guy G.; Steffens, David C.

    2015-01-01

    Although major depression has been considered as a manifestation of discoordinated activity between affective and cognitive neural networks, only a few studies have examined the relationships among neural networks directly. Because of the known disconnection theory, geriatric depression could be a useful model in studying the interactions among different networks. In the present study, using independent component analysis to identify intrinsically connected neural networks, we investigated the alterations in synchronizations among neural networks in geriatric depression to better understand the underlying neural mechanisms. Resting-state fMRI data was collected from thirty-two patients with geriatric depression and thirty-two age-matched never-depressed controls. We compared the resting-state activities between the two groups in the default-mode, central executive, attention, salience, and affective networks as well as correlations among these networks. The depression group showed stronger activity than the controls in an affective network, specifically within the orbitofrontal region. However, unlike the never-depressed controls, geriatric depression group lacked synchronized/antisynchronized activity between the affective network and the other networks. Those depressed patients with lower executive function has greater synchronization between the salience network with the executive and affective networks. Our results demonstrate the effectiveness of the between-network analyses in examining neural models for geriatric depression. PMID:26180795

  16. Altered Synchronizations among Neural Networks in Geriatric Depression.

    PubMed

    Wang, Lihong; Chou, Ying-Hui; Potter, Guy G; Steffens, David C

    2015-01-01

    Although major depression has been considered as a manifestation of discoordinated activity between affective and cognitive neural networks, only a few studies have examined the relationships among neural networks directly. Because of the known disconnection theory, geriatric depression could be a useful model in studying the interactions among different networks. In the present study, using independent component analysis to identify intrinsically connected neural networks, we investigated the alterations in synchronizations among neural networks in geriatric depression to better understand the underlying neural mechanisms. Resting-state fMRI data was collected from thirty-two patients with geriatric depression and thirty-two age-matched never-depressed controls. We compared the resting-state activities between the two groups in the default-mode, central executive, attention, salience, and affective networks as well as correlations among these networks. The depression group showed stronger activity than the controls in an affective network, specifically within the orbitofrontal region. However, unlike the never-depressed controls, geriatric depression group lacked synchronized/antisynchronized activity between the affective network and the other networks. Those depressed patients with lower executive function has greater synchronization between the salience network with the executive and affective networks. Our results demonstrate the effectiveness of the between-network analyses in examining neural models for geriatric depression. PMID:26180795

  17. Nursing: Registered Nurses

    MedlinePlus

    ... nurses for jobs in health planning and development, marketing, consulting, policy development, and quality assurance. Some RNs ... workers was $36,200. Recommend this page using: Facebook Twitter LinkedIn tools Areas at a Glance Industries ...

  18. Dealing with the patient's body in nursing: nurses' ambiguous experience in clinical practice.

    PubMed

    Picco, Elisa; Santoro, Roberto; Garrino, Lorenza

    2010-03-01

    The core of nursing in western countries is interaction with the patient and with his/her body in particular. As all nursing practices revolve around caring for the patient's body, nurses need to understand the frailty of the body, the intimacy surrounding it, the story it tells, as well as the discomfort and difficulties both illness and close contact can generate in the nurse-patient relationship. With this study, we wanted to explore the ward experiences of a small group of nurses in their day-to-day interaction with patients and their bodies, to highlight their perceptions and possible difficulties in providing care. We collected qualitative data from in-depth interviews with 14 nurses working in departments of general internal medicine, neurology, and geriatrics. The interviews were conducted between April and June 2006 and interpreted using an interpretive phenomenological approach. Analysis of the interview transcripts revealed that while the nurses recognize the centrality of the body in nursing, they also expressed a certain ambiguity toward it: being able to improve a patient's well-being through attentive care to the body is a major source of job satisfaction, but various coping and defense strategies are deployed to overcome care-giving situations that elicit avoidance or refusal reactions to the patient's body. PMID:20137029

  19. Fieldwork Rotation: A Model for Educating Social Work Students for Geriatric Social Work Practice

    ERIC Educational Resources Information Center

    Ivry, Joann; Lawrance, Frances P.; Damron-Rodriguez, JoAnn; Robbins, Virginia Cooke

    2005-01-01

    The Geriatric Social Work Practicum Partnership Program was funded to attract graduate students to the field of aging and to strengthen field education in geriatric social work. Rotation was selected to achieve the program's goals to provide students with exposure to the spectrum of care in geriatric social work services. This paper describes the…

  20. Geriatric-Focused Educational Offerings in the Department of Veterans Affairs from 1999 to 2009

    ERIC Educational Resources Information Center

    Thielke, Stephen; Tumosa, Nina; Lindenfeld, Rivkah; Shay, Kenneth

    2011-01-01

    The scope of geriatrics-related educational offerings in large health care systems, in either the target audiences or topics covered, has not previously been analyzed or reported in the professional literature. The authors reviewed the geriatrics-related educational sessions that were provided between 1999 and 2009 by the Geriatrics Research,…

  1. Geriatric Pharmacy Curriculum in U.S. Pharmacy Schools: A Nationwide Survey.

    ERIC Educational Resources Information Center

    Simonson, William; Pratt, Clara Collette

    1982-01-01

    A survey of 72 pharmacy schools shows 22 percent of the schools had no geriatric coursework, 35 percent offered only courses in which the geriatric content averaged under 12 percent of course content, and 43 percent offered courses that focused primarily on geriatrics, most including a major clinical component. (Author/MSE)

  2. Three Strategies for Delivering Continuing Medical Education in Geriatrics to General Practitioners

    ERIC Educational Resources Information Center

    Rikkert, Marcel G. M.; Rigaud, Anne-Sophie

    2004-01-01

    General practitioners (GPs) need advanced skills in geriatric assessment to be competent to treat the increasing number of elderly patients. Continuing medical education in geriatrics for GPs is heterogeneous, and not assessed for effectiveness. In this study we compared the educational effects of three geriatric post-graduate training methods on…

  3. Detection and documentation of dementia and delirium in acute geriatric wards.

    PubMed

    Laurila, Jouko V; Pitkala, Kaisu H; Strandberg, Timo E; Tilvis, Reijo S

    2004-01-01

    Detection of cognitive impairment among hospitalized older individuals has shown to be insufficient. A point prevalence study in two geriatric hospitals in Helsinki, Finland, was performed among 219 acutely ill individuals over 70 years to assess the detection of dementia and delirium. Documentation of dementia and delirium in medical records, and recordings of confusional symptoms in nurses' notes were compared with the researchers' diagnosis made after a detailed assessment of cognitive status. The cognitive decline was mentioned in medical records in 70/88 (79.5%) of the cases. Cognitive testing was performed on 42/88 (47.7%) of the dementia patients, and the diagnosis of dementia was recorded in 47/88 (53.4%) of them. A specific etiological diagnosis was recorded in only 4/88 (4.5%) cases. Cognitive impairment in at least one of these four means was recorded in 80/88 (90.9%) of cases (sensitivity 0.93). Eight patients had a false-positive diagnosis of dementia (specificity 0.94). Delirium was diagnosed in 77 (35.2%) patients by the researchers, but it was recorded in only 31/77 (40.3%) in medical records. In 64/77 (83.1%) cases signs of confusion were recorded in nurses' notes. Poor detection and documentation may lead to undertreatment of both disorders. PMID:14757300

  4. Geriatrics Education Team Model Results in Sustained Geriatrics Training in 15 Residency and Fellowship Programs and Scholarship.

    PubMed

    Denson, Steven; Simpson, Deborah; Denson, Kathryn; Brown, Diane; Manzi, Gabriel; Rehm, Judith; Wessel, Bambi; Duthie, Edmund H

    2016-04-01

    Caring for the growing elderly population will require specialty and subspecialty physicians who have not completed geriatric medicine fellowship training to participate actively in patient care. To meet this workforce demand, a sustainable approach to integrating geriatrics into specialty and subspecialty graduate medical education training is needed. This article describes the use of a geriatrics education team (GET) model to develop, implement, and sustain specialty-specific geriatrics curricula using a systematic process of team formation and needs assessment through evaluation, with a unique focus on developing curricular interventions that are meaningful to each specialty and satisfy training, scholarship, and regulatory requirements. The GET model and associated results from 15 specialty residency and fellowship training programs over a 4-year period include 93% curriculum sustainability after initial implementation, more than half of the programs introducing additional geriatrics education, and more than 80% of specialty GETs fulfilling their scholarship requirements through their curriculum dissemination. Win-wins and barriers encountered in using the GET model, along with the model's efficacy in curriculum development, sustainability, and dissemination, are summarized. PMID:27021702

  5. The experiences of undergraduate nursing students with bots in Second LifeRTM

    NASA Astrophysics Data System (ADS)

    Rose, Lesele H.

    As technology continues to transform education from the status quo of traditional lecture-style instruction to an interactive engaging learning experience, students' experiences within the learning environment continues to change as well. This dissertation addressed the need for continuing research in advancing implementation of technology in higher education. The purpose of this phenomenological study was to discover more about the experiences of undergraduate nursing students using standardized geriatric evaluation tools when interacting with scripted geriatric patient bots tools in a simulated instructional intake setting. Data was collected through a Demographics questionnaire, an Experiential questionnaire, and a Reflection questionnaire. Triangulation of data collection occurred through an automatically created log of the interactions with the two bots, and by an automatically recorded log of the participants' movements while in the simulated geriatric intake interview. The data analysis consisted of an iterative review of the questionnaires and the participants' logs in an effort to identify common themes, recurring comments, and issues which would benefit from further exploration. Findings revealed that the interactions with the bots were perceived as a valuable experience for the participants from the perspective of interacting with the Geriatric Evaluation Tools in the role of an intake nurse. Further research is indicated to explore instructional interactions with bots in effectively mastering the use of established Geriatric Evaluation Tools.

  6. More than a prescriber: gerontological nurse practitioners' perspectives on prescribing and pharmaceutical marketing.

    PubMed

    Mahoney, Diane Feeney; Ladd, Elissa

    2010-01-01

    The purpose of this study was to gain understanding about nurse practitioners' (NPs') prescriptive decision making for geriatric patients with attention to pharmaceutical marketing influences. Prior research has focused on physician prescribers and identified suboptimal practices. Because the majority of medications are prescribed to older adults, NPs in geriatric practice were targeted as an information-rich group to interview about prescribing issues. Given the exploratory nature of this research, qualitative focus group methods were employed using content analysis. Fifteen NPs were recruited at an annual national geriatric NP conference. They worked in all regions of the United States, had an average of 9 years prescribing experience, and participated in 1 of the 2 focus groups. The key theme that emerged was that they were more than a prescriber. Findings revealed overwhelming consistency among the NP participants that their nursing background instilled a holistic approach that encompassed both nondrug and therapeutic drug options and skepticism about drug marketing, as well as offered a positive difference by tailoring to their patients' biophysical, psychological, and economic needs with an involvement in the interplay of geriatric care issues not typically addressed by physicians. The participants' reported approaches were in alignment with geriatric prescribing recommendations. PMID:20159350

  7. [Electrolyte disturbances in geriatric patients with focus on hyponatremia].

    PubMed

    Grundmann, F

    2016-08-01

    Disturbances of water and electrolyte balance are commonly encountered in older patients due to a multitude of physiological changes and preexisting morbidities with hyponatremia being the most common disorder. Even mild chronic hyponatremia can lead to cognitive deficits and gait instability and is associated with an increased rate of falls and fractures. Additionally, experimental and epidemiological data suggest that hyponatremia promotes bone resorption and therefore increases the risk of osteoporosis. Furthermore, osteoporosis and sarcopenia can be stimulated by hypomagnesemia. Hypernatremia often only results in unspecific symptoms but the condition is associated with a clearly increased mortality. As electrolyte disturbances have a high prevalence in the geriatric population and can contribute to geriatric syndromes and frailty, relevant electrolyte alterations should be excluded in all geriatric patients, in particular after a change in medication schedules. PMID:27464739

  8. Increasing geriatric social work content through university/community partnerships.

    PubMed

    McCaslin, Rosemary; Barnstable, Cherie Lynn

    2008-01-01

    Since their inception, social work education programs have operated in partnership with community agencies, as both field sites and foci for research. However, surprisingly little has been written on models of university/community partnerships in social work or the role of agencies in shaping curricula. This study analyzed the outcome reports of 67 Council on Social Work Education Geriatric Enrichment Projects (Gero Rich), funded by the Hartford Foundation, that sought to infuse geriatric content throughout the foundation curricula of B.S.W. and M.S.W. programs. Using both quantitative and qualitative analyses, the structures and functions of the programs' university/community partnerships were examined along with their association with the sustainability of curriculum change efforts. Findings suggest that these partnerships were a critical component in increasing and sustaining geriatric curricular content and were beneficial for faculty, students, and agencies. PMID:19042224

  9. What to Expect From the Evolving Field of Geriatric Cardiology.

    PubMed

    Bell, Susan P; Orr, Nicole M; Dodson, John A; Rich, Michael W; Wenger, Nanette K; Blum, Kay; Harold, John Gordon; Tinetti, Mary E; Maurer, Mathew S; Forman, Daniel E

    2015-09-15

    The population of older adults is expanding rapidly, and aging predisposes to cardiovascular disease. The principle of patient-centered care must respond to the preponderance of cardiac disease that now occurs in combination with the complexities of old age. Geriatric cardiology melds cardiovascular perspectives with multimorbidity, polypharmacy, frailty, cognitive decline, and other clinical, social, financial, and psychological dimensions of aging. Although some assume that a cardiologist may instinctively cultivate some of these skills over the course of a career, we assert that the volume and complexity of older cardiovascular patients in contemporary practice warrants a more direct approach to achieve suitable training and a more reliable process of care. We present a rationale and vision for geriatric cardiology as a melding of primary cardiovascular and geriatrics skills, thereby infusing cardiology practice with expanded proficiencies in diagnosis, risks, care coordination, communications, end-of-life, and other competences required to best manage older cardiovascular patients. PMID:26361161

  10. Geriatric epilepsy: research and clinical directions for the future.

    PubMed

    Roberson, Erik D; Hope, Omotola A; Martin, Roy C; Schmidt, Dieter

    2011-09-01

    There is a growing awareness of the need for improved treatment and care of older adults with epilepsy. The present review article highlights key clinical and research issues in the emerging field of geriatric epilepsy. Drs. Martin and Schmidt explore the scope of the problems in the field, outline topic areas including cognitive health/dementia, and diagnostic challenges, and also present important research questions that should be considered for the future. As part of this presentation, we will highlight the work of two promising young investigators whose work holds great promise for the field of geriatric epilepsy. Dr. Roberson will discuss his work focusing on the relationship of epilepsy and cognitive impairment, particularly as it relates to Alzheimer's disease pathology including tau and its role in epileptiform activity. Dr. Hope will outline key issues, as well as her work, relating to defining and measuring quality care in geriatric epilepsy. PMID:21596624

  11. [Health care of geriatric patients with urinary incontinence].

    PubMed

    Mueller, Edgar A; Kirch, Wilhelm

    2015-04-01

    Urinary incontinence occurs frequently in geriatric patients. In the doctor's practice, the symptoms are often not mentioned by the patients; this may lead to loss of autonomy and social isolation. A screening for urinary incontinence should therefore be part of each geriatric assessment. In the presence of urinary incontinence, several treatment options are available, which need to be tailored according to the individual capabilities (mobility, motivation and cognitive performance) of the patient. Non-pharmacological treatment options, such as behavior modification, toilet training and pelvic floor training, should be exploited before any pharmacotherapy commences. If the pharmacological treatment involves the use of anticholinergic agents, the cognitive performance should be monitored. An interdisciplinary collaboration is a prerequisite for the optimized treatment and adequate health care of geriatric patients with urinary incontinence. PMID:25826038

  12. Standpoints of traditional Persian physicians on geriatric nutrition.

    PubMed

    Emami, Morteza; Nazarinia, Mohammad Ali; Rezaeizadeh, Hussein; Zarshenas, Mohammad M

    2014-10-01

    The present article aimed to compile information on the nutritional management for geriatric people. Popular textbooks of Persian medicine from 10th to 18th century were studied to derive relative viewpoints and considerations. The temperament, which is defined as the combination of 4 main elements (fire, air, water, and soil) and 4 humors made subsequently (black bile, yellow bile, phlegm, and blood), changes during age periods. Imbalance in proportional amounts of humors in elderly should be corrected with food and medicaments having opposite nature to the current condition. Traditional foods included mostly well-cooked soups, pottages, and porridges containing fresh sheep or chicken meat. Mono-ingredient foods were also administered according to their medical properties. Nutritional recommendations were also concerned with geriatrics' physiological conditions such as constipation, sleep disorders, and memory deficits. Many of traditional geriatric nutritional requirements are relevant in the present day. However, there are still notes that may be beneficial for consideration. PMID:25053755

  13. Economic viability of geriatric hip fracture centers.

    PubMed

    Clement, R Carter; Ahn, Jaimo; Mehta, Samir; Bernstein, Joseph

    2013-12-01

    Management of geriatric hip fractures in a protocol-driven center can improve outcomes and reduce costs. Nonetheless, this approach has not spread as broadly as the effectiveness data would imply. One possible explanation is that operating such a center is not perceived as financially worthwhile. To assess the economic viability of dedicated hip fracture centers, the authors built a financial model to estimate profit as a function of costs, reimbursement, and patient volume in 3 settings: an average US hip fracture program, a highly efficient center, and an academic hospital without a specific hip fracture program. Results were tested with sensitivity analysis. A local market analysis was conducted to assess the feasibility of supporting profitable hip fracture centers. The results demonstrate that hip fracture treatment only becomes profitable when the annual caseload exceeds approximately 72, assuming costs characteristic of a typical US hip fracture program. The threshold of profitability is 49 cases per year for high-efficiency hip fracture centers and 151 for the urban academic hospital under review. The largest determinant of profit is reimbursement, followed by costs and volume. In the authors’ home market, 168 hospitals offer hip fracture care, yet 85% fall below the 72-case threshold. Hip fracture centers can be highly profitable through low costs and, especially, high revenues. However, most hospitals likely lose money by offering hip fracture care due to inadequate volume. Thus, both large and small facilities would benefit financially from the consolidation of hip fracture care at dedicated hip fracture centers. Typical US cities have adequate volume to support several such centers. PMID:24579222

  14. Quality of Care Delivered Before versus After A Quality Improvement Intervention for Acute Geriatric Trauma

    PubMed Central

    Min, Lillian; Cryer, Henry; Chan, Chiao-Li; Roth, Carol; Tillou, Areti

    2014-01-01

    Background Older trauma injury patients had improved recovery after we implemented routine geriatric consultation for patients ≥ age 65 at a level-1 academic trauma center. The intervention aimed to improve quality of geriatric care. However, the specific care processes that improved are unknown. Study Design Prospective observation comparing medical care after (December 2007-November 2009) versus before (December 2006-November 2007) implementation of the geriatric consult-based intervention. To measure quality-of-care (QOC) we used 33 previously-validated care-process quality indicators (QIs) from the Assessing the Care of Vulnerable Elders (ACOVE) study, measured by review of medical records for 76 Geriatric Consult [GC] versus 71 control group patients. As pre-specified subgroup analyses, we aggregated QIs by type: geriatric (e.g., delirium screening) versus non-geriatric condition-based care (e.g., thrombosis prophylaxis) and compared QI scores by type of care. Last, we aggregated QI scores into overall, geriatric, and non-geriatric QOC scores for each patient (# QIs passed/# QIs eligible), and compared patient-level QOC for the GC versus control group, adjusting for age, gender, ethnicity, comorbidity, and injury severity. Results 63% of the GC versus 11% of the control group patients received a geriatric consultation. We evaluated 2505 QIs overall (1664 geriatric-type and 841 non-geriatric QIs). In general, fewer geriatric-type QIs were passed than non-geriatric QIs (71% vs 81%, p<.001). We provided better overall-QOC to the GC (77%) than control group patients (73%, p<.05). However, the difference was not statistically significant after multivariable adjustment (p=.08). We improved geriatric-QOC for the GC (74%) compared to the control group (68%, p<.01), a difference that was significant after multivariable adjustment (p=.01). Conclusion Geriatricians and surgeons can collaboratively improve geriatric QOC for older trauma patients. PMID:25840534

  15. Fried frailty phenotype assessment components as applied to geriatric inpatients

    PubMed Central

    Bieniek, Joanna; Wilczyński, Krzysztof; Szewieczek, Jan

    2016-01-01

    Background Management of geriatric patients would be simplified if a universally accepted definition of frailty for clinical use was defined. Among definitions of frailty, Fried frailty phenotype criteria constitute a common reference frame for many geriatric studies. However, this reference frame has been tested primarily in elderly patients presenting with relatively good health status. Objective The aim of this article was to assess the usefulness and limitations of Fried frailty phenotype criteria in geriatric inpatients, characterized by comorbidity and functional impairments, and to estimate the frailty phenotype prevalence in this group. Patients and methods: Five hundred consecutive patients of the university hospital subacute geriatric ward, aged 79.0±8.4 years (67% women and 33% men), participated in this cross-sectional study. Comprehensive geriatric assessment and Fried frailty phenotype component evaluation were performed in all patients. Results Multimorbidity (6.0±2.8 diseases) characterized our study group, with a wide range of clinical conditions and functional states (Barthel Index of Activities of Daily Living 72.2±28.2 and Mini-Mental State Examination 23.6±7.1 scores). All five Fried frailty components were assessed in 65% of patients (95% confidence interval [CI] =60.8–69.2) (diagnostic group). One or more components were not feasible to be assessed in 35% of the remaining patients (nondiagnostic group) because of lack of past patient’s body mass control and/or cognitive or physical impairment. Patients from the nondiagnostic group, as compared to patients from the diagnostic group, presented with more advanced age, higher prevalence of dementia, lower prevalence of hypertension, lower systolic and diastolic blood pressure, body mass index, Mini-Mental State Examination and Barthel Index of Activities of Daily Living. Despite diagnostic limitations, we found ≥3 positive criteria (thus, frailty diagnosis) in 54.2% of the study group

  16. A systematic approach to pharmacotherapy for geriatric major depression.

    PubMed

    Mulsant, Benoit H; Blumberger, Daniel M; Ismail, Zahinoor; Rabheru, Kiran; Rapoport, Mark J

    2014-08-01

    The broadening use of antidepressants among older Americans has not been associated with a notable decrease in the burden of geriatric depression. This article, based on a selective review of the literature, explores several explanations for this paradox. The authors propose that the effectiveness of antidepressants depends in large part on the way they are used. Evidence supports that antidepressant pharmacotherapy leads to better outcomes when guided by a treatment algorithm as opposed to attempting to individualize treatment. Several published guidelines and pharmacotherapy algorithms developed for the treatment of geriatric depression are reviewed, and an updated algorithm proposed. PMID:25037293

  17. Demographics of health and disease in the geriatric horse.

    PubMed

    Paradis, Mary Rose

    2002-12-01

    Owners of older horses have generally owned them for a long time. They have developed a bond that is similar to that seen with companion animals. Their desire to have their animal(s) age gracefully with comfort and mobility has stirred research in the field of equine geriatric medicine. Equine geriatric medicine is to the first decade of the twenty-first century as neonatal medicine was to the 1980s. Hopefully, the demographics discussed in this article highlight area where research can be most helpful. PMID:12516924

  18. Need for geriatric dentistry training programs in Iran.

    PubMed

    Mir, Arash Poorsattar Bejeh

    2013-01-01

    A shifting pattern from communicable diseases to the chronic noncommunicable diseases and increased life expectancy are being sensed throughout the world. Aged populations with multiple chronic diseases come up with their unique needs and require specific attention to be challenged by the health systems. Neglected orodental facts among the elders and the dearth of specific designated undergraduate and postgraduate courses of geriatric dentistry in Iran inevitably adversely affect the delivery of appropriate dental care service to elders by untrained dentists. In this article, a proposal for academic geriatric dentistry courses in Iran is introduced and highlighted with regards to elders' special needs. PMID:23314475

  19. ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management.

    PubMed

    Steinman, Theodore I

    2002-01-01

    The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs. PMID:11952931

  20. Measuring anxiety in late life: a psychometric examination of the geriatric anxiety inventory and geriatric anxiety scale.

    PubMed

    Gould, Christine E; Segal, Daniel L; Yochim, Brian P; Pachana, Nancy A; Byrne, Gerard J; Beaudreau, Sherry A

    2014-12-01

    We examined the psychometric properties, internal scale reliability and validity, of two geriatric anxiety measures: the Geriatric Anxiety Inventory (GAI) and Geriatric Anxiety Scale (GAS). We also determined the extent to which memory ability influenced the psychometric properties of these measures. Older adult participants (N=110; M age=75 years) completed self-report, clinician-rated and diagnostic psychiatric measures and a neuropsychiatric battery. GAI and GAS scores had good internal consistency, adequate reliability, and strong convergent validity. GAI scores had better discriminant validity than GAS scores relative to a health rating. Both measures had strong associations with depression scores. Psychometric properties were decreased in participants with average delayed memory recall compared with those with superior recall. Both measures had good psychometric support, particularly in those with strong memory abilities. Psychometric performance characteristics indicate that the GAI and GAS may be good alternatives to anxiety measures not designed specifically for older adults. PMID:25271176

  1. Nutritional status assessment in geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology Nutrition Work Group.

    PubMed

    Camina-Martín, M Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, J Antonio; Redondo-del-Río, M Paz

    2015-07-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, because elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología, SEGG) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories seeks to aid in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment associated to laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is to further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. PMID:26025067

  2. [Nutritional status assessment in Geriatrics: Consensus declaration by the Spanish Society of Geriatrics and Gerontology NutritionWork Group].

    PubMed

    Camina-Martín, María Alicia; de Mateo-Silleras, Beatriz; Malafarina, Vincenzo; Lopez-Mongil, Rosa; Niño-Martín, Virtudes; López-Trigo, José Antonio; Redondo-Del-Río, María Paz

    2016-01-01

    Ongoing population ageing is one of the factors influencing the increase in the prevalence of undernutrition, as elderly people are a vulnerable group due to their biological, psychological and social characteristics. Despite its high prevalence, undernutrition is underdiagnosed in the geriatric sphere. For this reason, the aim of this consensus document is to devise a protocol for geriatric nutritional assessment. A multidisciplinary team has been set up within the Spanish Society of Geriatrics and Gerontology (in Spanish Sociedad Española de Geriatría y Gerontología [SEGG]) in order to address undernutrition and risk of undernutrition so that they can be diagnosed and treated in an effective manner. The MNA-SF is a practical tool amongst the many validated methods for nutritional screening. Following suspicion of undernutrition, or after establishing the presence of undernutrition, a full assessment will include a detailed nutritional history of the patient. The compilation of clinical-nutritional and dietetic histories is intended to help in identifying the possible risk factors at the root of a patient's undernutrition. Following this, an anthropometric assessment, combined with laboratory data, will describe the patient's physical and metabolic changes associated to undernutrition. Currently, the tendency is for further nutritional assessment through the use of non-invasive techniques to study body composition in association with functional status. The latter is an indirect index for nutritional status, which is very interesting from a geriatrician's point of view. To conclude, correct nutritional screening is the fundamental basis for an early undernutrition diagnosis and to assess the need for nutritional treatment. In order to achieve this, it is fundamental to foster research in the field of nutritional geriatrics, in order to expand our knowledge base and to increasingly practice evidence-based geriatrics. PMID:26388249

  3. Developing advanced nursing skills for frail older people.

    PubMed

    Goldberg, Sarah; Cooper, Jo; Russell, Catherine

    2014-05-01

    Improving hospital care for frail older people requires expertise, leadership and resources as these patients have multiple complex needs. One innovative solution to providing the skilled care necessary is to train experienced nurses to become advanced nurse practitioners (ANPs). Such roles encompass activity previously undertaken by medical staff, together with leadership, teaching, research and service development. Skills specific to caring for older people, such as comprehensive geriatric assessment, are also required. This article discusses the need for ANPs in this clinical area, a pilot that is under way in one acute trust to develop these roles, and the potential benefits and challenges that may accompany this development. PMID:24787943

  4. Acute lower gastrointestinal hemorrhages in geriatric patients.

    PubMed

    Ríos, Antonio; Montoya, Mariano J; Rodríguez, José Manuel; Serrano, Andrés; Molina, Joaquín; Parrilla, Pascual

    2005-05-01

    Age is a risk factor in acute lower gastrointestinal hemorrhages (LGIH). The objectives here were to analyze: (1) diagnostic and therapeutic handling, (2) related morbidity and mortality, (3) the indications for surgery, and (4) the evolution of acute LGIH in patients > or =80 years. Forty-three patients >80 years with acute LGIH were reviewed retrospectively. In 86% (n = 37) related comorbidities were found, in 9% (n = 4) there had been prior colorectal surgery, 19% (n = 8) were antiaggregated, and 7% (n = 3) were anticoagulated. One hundred thirty-two cases of acute LGIH in patients <80 years were used as a control group. Student's t test and the chi-square test were applied. On arrival at the emergency ward 11 cases (26%) had hemodynamic instability and 8 of these were stabilized using conservative measures. In 39 cases an endoscopy was performed, allowing for an etiological diagnosis in 59% (n = 23) of cases, above all in those carried out in an urgent or semiurgent way. The arteriography permitted an etiological diagnosis in two of the four cases in which it was carried out. In seven patients (16%) urgent surgery was indicated: three were hemorrhoidectomies, three were subtotal colectomies, and one was a resection of the small intestine. The morbidity rate was 10% (n = 4) in the patients who were not treated and 14% (n = 1) in those treated, with a mortality rate of 8% (n = 3) and 14% (n = 1), respectively. The rate of relapse of bleeding after discharge from hospital was 42% (n = 18), with nine of these needing to be readmitted into hospital. In comparison with the control group, they present a different bleeding etiology (diverticulosis as opposed to the benign anal-rectal and small intestinal pathology in the younger population; P = 0.017), surgery is indicated with less frequency (9 versus 33%; P = 0.007), and there is a higher relapse rate (42 versus 26%; P = 0.045). Acute LGIH in geriatric patients relents in most cases with the use of conservative

  5. A Reliability Generalization Study of the Geriatric Depression Scale.

    ERIC Educational Resources Information Center

    Kieffer, Kevin M.; Reese, Robert J.

    2002-01-01

    Conducted a reliability generalization study of the Geriatric Depression Scale (T. Brink and others, 1982). Results from this investigation of 338 studies shows that the average score reliability across studies was 0.8482 and identifies the most important predictors of score reliability. (SLD)

  6. Confirmatory Factor Analysis of the Geriatric Depression Scale

    ERIC Educational Resources Information Center

    Adams, Kathryn Betts; Matto, Holly C.; Sanders, Sara

    2004-01-01

    Purpose: The Geriatric Depression Scale (GDS) is widely used in clinical and research settings to screen older adults for depressive symptoms. Although several exploratory factor analytic structures have been proposed for the scale, no independent confirmation has been made available that would enable investigators to confidently identify scores…

  7. Medical Readers' Theater: Relevance to Geriatrics Medical Education

    ERIC Educational Resources Information Center

    Shapiro, Johanna; Cho, Beverly

    2011-01-01

    Medical Readers' Theater (MRT) is an innovative and simple way of helping medical students to reflect on difficult-to-discuss topics in geriatrics medical education, such as aging stereotypes, disability and loss of independence, sexuality, assisted living, relationships with adult children, and end-of-life issues. The authors describe a required…

  8. Maximizing the Potential of Internships in Gerontology and Geriatrics

    ERIC Educational Resources Information Center

    Karasik, Rona J.

    2009-01-01

    Internships and similar applied opportunities have long been valued for providing students with opportunities for practical experience, career preparation, and personal growth. The need for applied experiences in gerontology and geriatrics is particularly salient. Creating and sustaining effective internship experiences, however, requires careful…

  9. [Patient satisfaction and geriatric care - an empirical study].

    PubMed

    Clausen, G; Borchelt, M; Janssen, C; Loos, S; Mull, L; Pfaff, H

    2006-02-01

    Patients' satisfaction has become a central concept in quality assurance. Despite progress in research in this area is still a lack of data for geriatric patients. Referring to the consumer model, satisfaction can be described as a difference between expectations and assessed performance. The aim of this study is to analyze satisfaction among geriatric patients in an in-patient setting. A personal interview was performed 1-2 days before discharge. Patients suffering for dementia or with problems to communicate were excluded. 124 of 268 geriatric patients who were discharged in 2003 were included (inclusion rate 46.3%). 119 were willing to participate (response rate 96.0%). Respondents were between 61 and 96 years old, 39% were male and 42% had serious functional limitations at time of admission. Multiple linear regression analysis revealed three significant predictors of a combined index of satisfaction and expectations: a) quality of hotel services; b) experience of neglect; c) provision of medical information and skills. In summary, standardized personal questionnaires can provide valid and reliable data of geriatric patients. Satisfaction of elderly patients is negatively affected by neglect and positively influenced by provision of medical information and a good hotel services. PMID:16502227

  10. Novel ethical dilemmas arising in geriatric clinical practice.

    PubMed

    Calleja-Sordo, Elisa Constanza; de Hoyos, Adalberto; Méndez-Jiménez, Jorge; Altamirano-Bustamante, Nelly F; Islas-Andrade, Sergio; Valderrama, Alejandro; García-Peña, Carmen; Altamirano-Bustamante, Myriam M

    2015-05-01

    The purpose of this study is to determine empirically the state of the art of the medical care, when healthcare personal is confronted with ethical dilemmas related with the care they give to the geriatric population. An observational, longitudinal, prospective and qualitative study was conducted by analyzing the correlation between healthcare personnel-patient relationship, and ethical judgments regarding dilemmas that arise in daily clinical practice with geriatric patients. Mexican healthcare personnel with current active practices were asked to write up an ethical dilemma that arose frequently or that had impacted their medical practice. From the narrative input, we were able to draw up a database with 421 dilemmas, and those corresponding to patients 60 years and older were selected (n = 54, 12.8 %). The axiological analysis of the narrative dilemmas of geriatric patients was made using dialectical empiricism. The axiological analysis values found most frequently were classified into three groups: the impact of healthcare, the roles of the physician, and refusal of therapy; the healthcare role of educator, caring for the patients' life and the risk of imminent death where the values found more often. The persistence and universality of certain dilemmas in geriatrics calls for awareness and requires a good training in the ethical discernment of these dilemmas. This would help to improve substantially the care and the life quality of this population. PMID:25185872

  11. Geriatric Education in the Health Professions: Are We Making Progress?

    ERIC Educational Resources Information Center

    Bardach, Shoshana H.; Rowles, Graham D.

    2012-01-01

    Purpose: Relative to the overall population, older adults consume a disproportionally large percentage of health care resources. Despite advocacy and efforts initiated more than 30 years ago, the number of providers with specialized training in geriatrics is still not commensurate with the growing population of older adults. This contribution…

  12. E-Learning Virtual Patients for Geriatric Education

    ERIC Educational Resources Information Center

    Orton, Eric; Mulhausen, Paul

    2008-01-01

    Computer-based virtual patients (VPs) are an emerging medium for medical education that addresses barriers faced by geriatrics educators. Research has shown VPs to be as effective in changing knowledge and behavior as more traditional forms of teaching. This paper presents a descriptive study of the development of the University of Iowa's…

  13. Use of Readers Theater to Enhance Interdisciplinary Geriatric Education

    ERIC Educational Resources Information Center

    MacRae, Nancy; Pardue, Karen T.

    2007-01-01

    This article focuses on the design and implementation of an interdisciplinary geriatric educational project at a small New England University. A novel, affective teaching approach of Readers Theater is highlighted as a beginning classroom instructional strategy for interdisciplinary students. The physical and psychosocial considerations for health…

  14. Culture Competence in the Training of Geriatric Medicine Fellows

    ERIC Educational Resources Information Center

    Tanabe, Marianne K. G.

    2007-01-01

    With the aging and diversifying of the elder population in the United States, there is a pressing need for an organized and effective curriculum in cultural competence. The Accreditation Council for Graduate Medical Education (ACGME) requires that the curriculum for Geriatric Medicine Fellowship training include cultural competency training.…

  15. A Web-Based Framework for Improving Geriatric Education

    ERIC Educational Resources Information Center

    Hirth, Victor A.; Hajjar, Ihab

    2004-01-01

    Despite the growth in the elderly population, physicians with special geriatric training and certification number only 9,000 out of 650,000 doctors in the United States. The flexibility and increasing availability of the Internet makes it an ideal avenue for addressing the educational needs of health care providers to improve the health and care…

  16. Rasch Analysis of the Geriatric Depression Scale--Short Form

    ERIC Educational Resources Information Center

    Chiang, Karl S.; Green, Kathy E.; Cox, Enid O.

    2009-01-01

    Purpose: The purpose of this study was to examine scale dimensionality, reliability, invariance, targeting, continuity, cutoff scores, and diagnostic use of the Geriatric Depression Scale-Short Form (GDS-SF) over time with a sample of 177 English-speaking U.S. elders. Design and Methods: An item response theory, Rasch analysis, was conducted with…

  17. Attendance At Activities With a Geriatric Population: Antecedents and Consequences.

    ERIC Educational Resources Information Center

    Neff, Dennis B.

    The effectiveness of various procedures in maintaining attendance at activities of residents at a geriatric facility was examined. A special, intermittently programmed or delayed consequence for attendance was added to regularly scheduled activities. Attendance at activities with and without the consequence was compared. Later, antecedent events…

  18. Geriatrics in Brazil: a big country with big opportunities.

    PubMed

    Garcez-Leme, Luiz E; Leme, Mariana Deckers; Espino, David V

    2005-11-01

    Brazil has approximately 180 million inhabitants, of whom 15.2 million are aged 60 and older and 1.9 million are aged 80 and older. By 2025, the Brazilian elderly population is expected to grow to more than 32 million. Brazil has many problems related to its geographic and population size. Great distances between major cities, marked cultural and racial heterogeneity between the various geographic regions, high poverty levels, and decreasing family size all combine to put pressure on the medical and social services that can be made available to the elder population. Less than 500 Brazilian physicians are certified as geriatricians, translating into one geriatrician for every 37,000 elderly Brazilians. Beside 15 geriatric medicine residencies a larger number of fellowship programs exist, and these programs are in high demand, with more than 20 candidates per position, indicating new opportunities for growth in elder care. In addition, geriatric initiatives such as the annual elder vaccination program and the elder statute, recently approved by the Brazilian Congress, indicate that geriatric care in Brazil is entering a new era of growth and development. Although the challenges remain great, there are opportunities for Brazilian geriatrics and gerontology. PMID:16274389

  19. Health Promotion/Disease Prevention: New Directions for Geriatric Education.

    ERIC Educational Resources Information Center

    Levkoff, Sue; And Others

    1996-01-01

    Describes 10 modules for primary care practitioners on health promotion/disease prevention for the elderly on these topics: Alzheimer's disease in minorities, dehydration, diabetes, elder abuse, geriatric nutrition, oncology, oral health in long-term care, incontinence, injury prevention, and physical activity. These areas are significant for…

  20. Comprehensive geriatric assessment basics for the cancer professional.

    PubMed

    Extermann, Martine

    2003-01-01

    A comprehensive geriatric assessment (CGA) has been a cornerstone of geriatric practice for many years. However, oncology practitioners are still unfamiliar with it. Yet, recent research has shown an important potential to improve the daily care of older cancer patients. The purpose of this article is to review the basic nature of a CGA, its effectiveness, its applicability to cancer patients, and its cost-effectiveness. Cancer is one of the major health problems in our society. Furthermore, the incidence of cancer increases with age. Nowadays, half of the cancers occur beyond the age of 70. Given the aging of the US population, this proportion is expected to increase in the next decades. A challenge for the oncologists is that older people can have a highly variable health status. Yet little is known yet about how to best assess and integrate into decision making the various health problems patients may have. Taking their clues from the experience of geriatricians, geriatric oncologists advocate the use of a comprehensive geriatric assessment (CGA) as one of the tools to deal with this problem. It is, for example, part of the National Comprehensive Cancer Network (NCCN) guidelines for the elderly'. This article offers a primer on CGA for the reader unfamiliar with the approach in an oncologic setting. PMID:12699111

  1. Clinical conundrums and challenges during geriatric orthopedic emergency surgeries

    PubMed Central

    Bajwa, Sukhminder Jit Singh

    2015-01-01

    Despite so many advancements and innovations in anesthetic techniques, expectations and challenges have also grown in plenty. Cardiac, pediatric, obstetric and neuro-anesthesia have perfectly developed to fulfill the desired needs of respective patient population. However, geriatric anesthesia has been shown a lesser interest in teaching and clinical practices over the years as compared with other anesthetic sub-specialties. The large growing geriatric population globally is also associated with an increase number of elderly patients presenting for orthopedic emergency surgeries. Orthopedic emergency surgery in geriatric population is not only a daunting clinical challenge but also has numerous socio-behavioral and economic ramifications. Decision making in anesthesia is largely influenced by the presence of co-morbidities, neuro-cognitive functions and the current socio-behavioral status. Pre-anesthetic evaluation and optimization are extremely important for a better surgical outcome but is limited by time constraints during emergency surgery. The current review aims to highlight comprehensively the various clinical, social, behavioral and psychological aspects during pre-anesthetic evaluation associated with emergency orthopedic surgery in geriatric population. PMID:25810963

  2. Expert Consensus Panel Guidelines on Geriatric Assessment in Oncology

    PubMed Central

    O'Donovan, A.; Mohile, S.G.; Leech, M.

    2015-01-01

    Introduction Despite consensus guidelines on best practice in the care of older patients with cancer, geriatric assessment (GA) has yet to be optimally integrated into the field of oncology in most countries. There is a relative lack of consensus in the published literature as to the best approach to take, and there is a degree of uncertainty as to how integration of geriatric medicine principles might optimally predict patient outcomes. The aim of the current study was to obtain consensus on GA in oncology to inform the implementation of a geriatric oncology programme. Methods A four round Delphi process was employed. The Delphi method is a structured group facilitation process, using multiple iterations in order to gain consensus on a given topic Results Consensus was reached on the optimal assessment method and interventions required for the commonly employed domains of GA. Other aspects of GA, such as screening methods and age cutoff for assessment represented a higher degree of disagreement. Discussion The expert panel employed in this study clearly identified the criteria that should be included in a clinical geriatric oncology programme. In the absence of evidence-based guidelines, this may prove useful in the care of older cancer patients. PMID:25757457

  3. Integrating Geriatric Dentistry into General Practice Residency Programs.

    ERIC Educational Resources Information Center

    Lloyd, Patrick M.; Shay, Kenneth

    1989-01-01

    The predoctoral dental curriculum cannot provide the depth of experience and knowledge needed for the increasing representation of geriatric patients in family dental practices. A curriculum model designed to enhance knowledge and refine clinical skills in caring for the elderly is proposed. (MSE)

  4. The Termination Phase in Group Therapy: Implications for Geriatric Groups.

    ERIC Educational Resources Information Center

    Eklof, Mona

    1984-01-01

    Hypothesizes that a geriatric counseling group would have a particularly difficult time with termination because of their unique position in relation to the issues of loss and dependency. Concludes that the major work of group therapy termination involves the issues of loss and separation anxiety. (LLL)

  5. Obtaining Self-Report Data from Cognitively Impaired Elders: Methodological Issues and Clinical Implications for Nursing Home Pain Assessment

    ERIC Educational Resources Information Center

    Fisher, Susan E.; Burgio, Louis D.; Thorn, Beverly E.; Hardin, J. Michael

    2006-01-01

    Purpose: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Design and Methods: Using a modification of the Geriatric Pain Measure (GPM-M2), we…

  6. Focus group reflections on the current and future state of cognitive assessment tools in geriatric health care

    PubMed Central

    Whitehead, Jocelyne C; Gambino, Sara A; Richter, Jeffrey D; Ryan, Jennifer D

    2015-01-01

    Objective This study provides insight into the thoughts and opinions of geriatric health-care professionals toward cognitive assessments and the use of emerging technologies, such as eye-tracking, to supplement current tools. Methods Two focus group sessions were conducted with nurses and physicians who routinely administer neurocognitive assessments to geriatric populations. Video recordings of the focus group sessions were transcribed and a thematic analysis was performed. Results Participants reported the need for assessment and diagnostic tools that are accessible and efficient, and that are capable of accommodating the rapid growth in the aging population. The prevalence of more complex ailments experienced by older adults has had repercussions in the quality of care that the clients receive, and has contributed to lengthy wait times and resource shortages. Health-care professionals stated that they are hampered by the disjointed structure of the health-care system and that they would benefit from a more efficient allocation of responsibilities made possible through tools that did not require extensive training or certification. Eyetracking-based cognitive assessments were thought to strongly complement this system, yet it was thought that difficulty would be faced in gaining the support and increased uptake by health-care professionals due to the nonintuitive relationship between eyetracking and cognition. Conclusion The findings suggest that health-care professionals are receptive to the use of eyetracking technology to assess for cognitive health as it would conserve resources by allowing frontline staff to administer assessments with minimal training. PMID:26109860

  7. "Pedogeriatrics": a pediatric nephrologist's outlook on common challenges facing pediatric and geriatric nephrologists.

    PubMed

    Grünberg, Jose

    2010-03-01

    Dramatic demographic changes longevity and medical progress helped create a new population made up of the survivors of previously fatal diseases. These trends pose new major social and economic challenges that should be accounted for in health policy making. This paper discusses the similarities between the specialties of pediatrics and geriatrics, especially in the realm of patient care. Children and the elderly share a limited autonomy and dependence on the human environment (i.e., willing and able caregiving persons) due to age or disease. The long-term care of dependent patients (DP) requires caregiving persons who share with dependent persons the risk of losing autonomy, facing burnout, family disruption, and interference with work and educational activities. Families with DPs may face potential losses of income because both patients and caregivers are partially or completely unable to work, the former for medical reasons and the latter due to the new demands on their time and energy. Additionally, new expenses have to be met because while direct medical expenses might be covered by insurance or the State, other expenses have to be financed by the family, such as co-payments for medicines, new water or electricity home installations, and transport and eventual hotel costs if they have to stay overnight near a hospital outside of their town. The main objectives of long-term care should be to maximize patients' independence and prevent their physical and psychological deterioration while minimizing the social, economic and personal costs to caregivers. To achieve these goals, one needs a holistic approach, a multidisciplinary professional team (doctors, nurses, social workers, nutritionists and psychologists) and auxiliary staff (secretaries, electricians, administrators, messengers, cleaning staff, doormen, nursing aids and coordinators of medical appointments and medical procedures). Optimal management of DPs on chronic treatments such as chronic dialysis

  8. Use of Geriatric Assessment for Older Adults in the Oncology Setting: A Systematic Review

    PubMed Central

    2012-01-01

    Background Geriatric assessment is a multidisciplinary diagnostic process that evaluates the older adult’s medical, psychological, social, and functional capacity. No systematic review of the use of geriatric assessment in oncology has been conducted. The goals of this systematic review were: 1) to provide an overview of all geriatric assessment instruments used in the oncology setting; 2) to examine the feasibility and psychometric properties of those instruments; and 3) to systematically evaluate the effectiveness of geriatric assessment in predicting or modifying outcomes (including the impact on treatment decision making, toxicity of treatment, and mortality). Methods We searched Medline, Embase, Psychinfo, Cinahl, and the Cochrane Library for articles published in English, French, Dutch, or German between January 1, 1996, and November 16, 2010, reporting on cross-sectional, longitudinal, interventional, or observational studies that assessed the feasibility or effectiveness of geriatric assessment instruments. The quality of articles was evaluated using relevant quality assessment frameworks. Results We identified 83 articles that reported on 73 studies. The quality of most studies was poor to moderate. Eleven studies examined psychometric properties or diagnostic accuracy of the geriatric assessment instruments used. The assessment generally took 10–45min. Geriatric assessment was most often completed to describe a patient’s health and functional status. Specific domains of geriatric assessment were associated with treatment toxicity in 6 of 9 studies and with mortality in 8 of 16 studies. Of the four studies that examined the impact of geriatric assessment on the cancer treatment decision, two found that geriatric assessment impacted 40%–50% of treatment decisions. Conclusion Geriatric assessment in the oncology setting is feasible, and some domains are associated with adverse outcomes. However, there is limited evidence that geriatric assessment

  9. Nursing Home Checklist

    MedlinePlus

    Nursing home checklist Name of nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing ...

  10. Nursing Handbook.

    ERIC Educational Resources Information Center

    New York State Education Dept., Albany. Office of the Professions.

    A handbook with laws, rules, and regulations of the State Education Department of New York governing nursing practice is presented. It describes licensure requirements and includes complete application forms and instructions for obtaining license and first registration as a licensed practical nurse and professional registered nurse. Applicants are…

  11. Geriatric Medicine Training for Family Practice Residents in the 21st Century: A Report from the Residency Assistance Program/Hartford Geriatrics Initiative.

    ERIC Educational Resources Information Center

    Warshaw, Gregg; Murphy, John; Buehler, James; Singleton, Stacy

    2003-01-01

    Summarizes the initial results of the regional geriatric medicine curriculum retreats for family practice residency directors provided as part of the American Academy of Family Physicians multi-part project to improve the amount and quality of geriatric medicine education received by family practice residents. (EV)

  12. American Nurses Association Nursing World

    MedlinePlus

    ... Annual Conference Join » Care Coordination: Capitalizing on the Nursing Role in Population Health --Register Now ! For more ... ANA » My ANA » Shop » ANA Nursing Knowledge Center Nursing Insider News 9/15/16 Update Your MyANA ...

  13. Nutrition for Nurses: Nursing 245.

    ERIC Educational Resources Information Center

    Palermo, Karen R.

    A description is presented of "Nutrition for Nurses," a prerequisite course for students anticipating entrance into the junior level of a state university registered nursing program. Introductory material highlights the course focus (i.e., the basics of good nutrition; nutrition through the life cycle; nursing process in nutritional care; and…

  14. Are Gold Standard Depression Measures Appropriate for Use in Geriatric Cancer Patients? A Systematic Evaluation of Self-Report Depression Instruments Used With Geriatric, Cancer, and Geriatric Cancer Samples

    PubMed Central

    Nelson, Christian J.; Cho, Christina; Berk, Alexandra R.; Holland, Jimmie; Roth, Andrew J.

    2010-01-01

    Purpose Geriatric issues in cancer are becoming prominent. Depression is a significant concern for both the elderly and patients with cancer, yet identifying depression in these patients is difficult and often leads to under-recognition. We conducted a systematic review to determine which depression instruments are appropriate for use in geriatric patients with cancer. Methods We identified the most commonly used self-report depression instruments. We then used the criteria established in the US Food and Drug Administration Draft Guidance on Patient-Reported Outcome Measures to determine the extent of validation evidence of these measures in geriatric cancer populations. Finally, we determined which instruments captured depressive symptoms that are common among elderly patients with cancer. Results Eight measures were selected as the most commonly used instruments. These were the Beck Depression Inventory-II, Brief Symptom Inventory-18, Center for Epidemiologic Studies–Depression Scale, Geriatric Depression Scale-15, Hospital Anxiety and Depression Scale, Patient Health Questionnaire-9, Profile of Mood States–Short Form, and Zung Self-Rating Depression Scale. Many have been validated for use with geriatric adults and patients with cancer; however, data addressing content validity and responder definition were lacking. To date, there is no validation information for geriatric patients with cancer. Furthermore, symptom profile analysis revealed that these measures do not identify many symptoms signaling depression in geriatric patients with cancer. Conclusion The validation evidence for use of common depression instruments in geriatric patients with cancer is lacking. This, and the possibility that these measures may not assess common depressive symptoms in geriatric patients with cancer, questions the adequacy of these scales in this population. PMID:19996030

  15. [Vitamin D. A geriatric updated perspective].

    PubMed

    Ribera Casado, José Manuel

    2012-01-01

    The aim of this review is to offer an updated survey about the relationship between old age, vitamin D and different clinical conditions. Two third of people over 65 years has insufficient serum levels of vitamin D (<30 ng/ml). Almost half of them present deficiency (<20 ng/ml), severe in many cases (<15 ng/ml). This proportion increases when we analyze non-white populations, women, and people with obesity, diabetes mellitus or diets poor in Vitamin D. Low serum vitamin D concentration has been linked to mortality, osteoporosis, falls propensity, fractures, frailty, and cardiovascular diseases, including hypertension. Several epidemiological studies open the possibility to a relationship between low levels of the vitamin D and many other diseases. Among them with different cancer, diabetes, some types of dementia, Parkinson's disease, macular degeneration or periodontitis. Also with muscle strength, mobility and physical performance. Vitamin D supplementation has beneficial clinical effects, with a significant reduction of risks, specially in subjects living in nursing-homes and in those treated with corticoids or antireabsortive drugs. These effects are doses dependent. Risk of intoxication is minimal, even with high doses of vitamin. PMID:24294732

  16. Reducing hospital admissions from nursing homes: a systematic review

    PubMed Central

    2014-01-01

    Background The geriatric nursing home population is vulnerable to acute and deteriorating illness due to advanced age, multiple chronic illnesses and high levels of dependency. Although the detriments of hospitalising the frail and old are widely recognised, hospital admissions from nursing homes remain common. Little is known about what alternatives exist to prevent and reduce hospital admissions from this setting. The objective of this study, therefore, is to summarise the effects of interventions to reduce acute hospitalisations from nursing homes. Methods A systematic literature search was performed in Cochrane Library, PubMed, MEDLINE, EMBASE and ISI Web of Science in April 2013. Studies were eligible if they had a geriatric nursing home study population and were evaluating any type of intervention aiming at reducing acute hospital admission. Systematic reviews, randomised controlled trials, quasi randomised controlled trials, controlled before-after studies and interrupted time series were eligible study designs. The process of selecting studies, assessing them, extracting data and grading the total evidence was done by two researchers individually, with any disagreement solved by a third. We made use of meta-analyses from included systematic reviews, the remaining synthesis is descriptive. Based on the type of intervention, the included studies were categorised in: 1) Interventions to structure and standardise clinical practice, 2) Geriatric specialist services and 3) Influenza vaccination. Results Five systematic reviews and five primary studies were included, evaluating a total of 11 different interventions. Fewer hospital admissions were found in four out of seven evaluations of structuring and standardising clinical practice; in both evaluations of geriatric specialist services, and in influenza vaccination of residents. The quality of the evidence for all comparisons was of low or very low quality, using the GRADE approach. Conclusions Overall, eleven

  17. Geriatric Rehabilitation Patients’ Perceptions of Unit Dining Locations

    PubMed Central

    Baptiste, Françoise; Egan, Mary; Dubouloz-Wilner, Claire-Jehanne

    2014-01-01

    Background Eating together is promoted among hospitalized seniors to improve their nutrition. This study aimed to understand geriatric patients’ perceptions regarding meals in a common dining area versus at the bedside. Methods An exploratory qualitative study was conducted. Open-ended questions were asked of eight patients recruited from a geriatric rehabilitation unit where patients had a choice of meal location. Results Eating location was influenced by compliance with the perceived rules of the unit, physical and emotional well-being, and quarantine orders. Certain participants preferred eating in the common dining room where they had more assistance from hospital staff, a more attractive physical environment, and the opportunity to socialize. However, other participants preferred eating at their bedsides, feeling the quality of social interaction was poor in the dining room. Conclusions Participants’ experiences of, and preferences for, communal dining differed. If the benefits of communal dining are to be maximized, different experiences of this practice must be considered. PMID:24883161

  18. History of geriatric medicine: from Hippocrates to Marjory Warren.

    PubMed

    Ritch, A

    2012-01-01

    It is widely assumed that geriatric medicine was an invention of the twentieth century. However, from the time of Hippocrates, there has been interest in the prolongation of the lifespan, the maintenance of health in old age and agerelated disease patterns. The debate about whether old age was a natural phenomenon or a disease state was not resolved until the nineteenth century. Calls for medicine relating to old age to be recognised as a discrete entity at the time when medical specialisation was developing were disregarded until the second half of the twentieth century. This review discusses the history of the theories of ageing and of disease and the practice of medicine for older people from the classical period up to Marjory Warren's initiative in London in 1935 and the development of geriatrics as a medical specialty. PMID:23240126

  19. Challenges in the pharmacological treatment of geriatric asthma.

    PubMed

    Agusta, Fabio; Battaglia, Salvatore; Benfante, Alida; Spatafora, Mario; Scichilone, Nicola

    2016-07-01

    Asthma in older populations is characterized by frequent comorbid conditions, which increase the risk of side effects and of detrimental interactions between respiratory and non-respiratory drugs. These observations lead to the need to manage asthma in older populations by applying a multidimensional assessment and a multidisciplinary treatment; therefore, we favor the use of the 'geriatric' term to define asthma in the elderly. Geriatric asthma is a complex disease, which may not necessarily imply that it is also complicated, although the two conditions may often coexist. On this basis, the switch from an organ-driven management to the holistic approach may be the key factor to attain optimal control of the disease in this age range. The current review discusses the age-related factors affecting asthma treatment in the oldest individuals, such as the comorbid conditions, and age-related changes of metabolism and excretion that can impair the efficacy and safety of drugs. PMID:26986042

  20. [Geriatric fracture centers. Improved patient care and economic benefits].

    PubMed

    Kates, S L

    2016-01-01

    The world's population is aging resulting in changes in the way we manage geriatric care. Furthermore, this population has a considerable risk of fragility fractures, most notably hip fractures. Hip fractures are associated with significant morbidity and mortality and have large economic consequences. It is due to these factors that the concept of an elderly trauma center was developed. These trauma centers utilize the expertise in orthopedic and geriatric disciplines to provide coordinated care to the elderly hip fracture patient. As a result, studies have demonstrated improvements in clinical outcomes within the hospital stay, a reduction in iatrogenic complications, and improvements in 1-year mortality rates compared to the usual care given at a similar facility. Furthermore, economic models have demonstrated that there is a role for regionalized hip fracture centers that can be both profitable and provide more efficient care to these patients. PMID:26658903

  1. E-learning virtual patients for geriatric education.

    PubMed

    Orton, Eric; Mulhausen, Paul

    2008-01-01

    Computer-based virtual patients (VPs) are an emerging medium for medical education that addresses barriers faced by geriatrics educators. Research has shown VPs to be as effective in changing knowledge and behavior as more traditional forms of teaching. This paper presents a descriptive study of the development of the University of Iowa's GeriaSims VP programs and their effectiveness as tools for geriatric education. More than 85% of the responses to an evaluation survey of GeriaSims users indicated favorable perceptions of instructional effectiveness, efficiency, and ease of use. GeriaSims VP programs were used effectively by multiple levels of learners and provide flexibility to these learners in scheduling their learning. PMID:18215989

  2. Cutaneous oncologic and cosmetic surgery in geriatric patients.

    PubMed

    Scheinfeld, Noah; Yu, Thomas; Weinberg, Jeffrey; Gordon, Marsha; Silapunt, Sirunya; Norman, Robert A; Alam, Murad

    2004-01-01

    A wide array of surgical procedures is available to geriatric patients. These interventions can enhance the appearance of patients and facilitate the removal of skin cancers. Pre-existing medical conditions of geriatric patients must be considered comprehensively when selecting and performing cutaneous surgical procedures. Many older patients suffer from a variety of diseases and take a variety of medications and herbal supplements to ameliorate the consequences of such diseases. In general, skin surgery can be performed safely on even very old patients, provided precautions are followed. The biopsychosocial well-being and essence of patients must also be addressed when performing dermatologic surgery. If patients are treated holistically and comprehensively, their surgical experience can be enhanced and their health and appearance improved. PMID:15018014

  3. Quality assurance in gerontological and geriatric training programs: the European case.

    PubMed

    Politynska, Barbara; van Rijsselt, René J T; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

    2012-01-01

    Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends, including the pros and cons of QA. Furthermore, the authors focus on accreditation and credit transfer opportunities in vocational and academic education programs for primary care practitioners, including nurses, home care workers, social workers, physiotherapists, and family doctors involved in the care of older people in nine European countries and highlight changes that have occurred over the last decade. Vocational education and professional training in elderly care at the basic and postgraduate specialization level remains extremely diversified, reflecting the lack of standardization for programs outside the higher education sector. The situation is ripe for the implementation of the European Qualifications Framework, which is intended to promote transparency, comparability and portability of qualifications at different levels and the introduction of a credit transfer system for vocational education to be established in 2012. PMID:22289065

  4. Challenges in the Management of Geriatric Obesity in High Risk Populations

    PubMed Central

    Porter Starr, Kathryn N.; McDonald, Shelley R.; Weidner, Julia A.; Bales, Connie W.

    2016-01-01

    The global prevalence of obesity in the older adult population is growing, an increasing concern in both the developed and developing countries of the world. The study of geriatric obesity and its management is a relatively new area of research, especially pertaining to those with elevated health risks. This review characterizes the state of science for this “fat and frail” population and identifies the many gaps in knowledge where future study is urgently needed. In community dwelling older adults, opportunities to improve both body weight and nutritional status are hampered by inadequate programs to identify and treat obesity, but where support programs exist, there are proven benefits. Nutritional status of the hospitalized older adult should be optimized to overcome the stressors of chronic disease, acute illness, and/or surgery. The least restrictive diets tailored to individual preferences while meeting each patient’s nutritional needs will facilitate the energy required for mobility, respiratory sufficiency, immunocompentence, and wound healing. Complications of care due to obesity in the nursing home setting, especially in those with advanced physical and mental disabilities, are becoming more ubiquitous; in almost all of these situations, weight stability is advocated, as some evidence links weight loss with increased mortality. High quality interdisciplinary studies in a variety of settings are needed to identify standards of care and effective treatments for the most vulnerable obese older adults. PMID:27153084

  5. Challenges in the Management of Geriatric Obesity in High Risk Populations.

    PubMed

    Porter Starr, Kathryn N; McDonald, Shelley R; Weidner, Julia A; Bales, Connie W

    2016-01-01

    The global prevalence of obesity in the older adult population is growing, an increasing concern in both the developed and developing countries of the world. The study of geriatric obesity and its management is a relatively new area of research, especially pertaining to those with elevated health risks. This review characterizes the state of science for this "fat and frail" population and identifies the many gaps in knowledge where future study is urgently needed. In community dwelling older adults, opportunities to improve both body weight and nutritional status are hampered by inadequate programs to identify and treat obesity, but where support programs exist, there are proven benefits. Nutritional status of the hospitalized older adult should be optimized to overcome the stressors of chronic disease, acute illness, and/or surgery. The least restrictive diets tailored to individual preferences while meeting each patient's nutritional needs will facilitate the energy required for mobility, respiratory sufficiency, immunocompentence, and wound healing. Complications of care due to obesity in the nursing home setting, especially in those with advanced physical and mental disabilities, are becoming more ubiquitous; in almost all of these situations, weight stability is advocated, as some evidence links weight loss with increased mortality. High quality interdisciplinary studies in a variety of settings are needed to identify standards of care and effective treatments for the most vulnerable obese older adults. PMID:27153084

  6. Shared medical appointments to screen for geriatric syndromes: preliminary data from a quality improvement initiative.

    PubMed

    May, Suepattra G; Cheng, Peter H; Tietbohl, Caroline K; Trujillo, Laurel; Reilly, Kelly; Frosch, Dominick L; Lin, Grace A

    2014-12-01

    Older adults are at greater risk of developing conditions that affect health outcomes, quality of life, and costs of care. Screening for geriatric conditions such as memory loss, fall risk, and depression may contribute to the prevention of adverse physical and mental comorbidities, unnecessary hospitalizations, and premature nursing home admissions. Because screening is not consistently performed in primary care settings, a shared medical appointment (SMA) program was developed to fill this gap in care. The goals of the program were to improve early identification of at-risk individuals and ensure appropriate follow-up for memory loss, fall risk, and depression; facilitate discussion about prevention, diagnosis, and treatment of these conditions; implement strategies to reduce risks for these conditions; and increase access to screening and expand preventive health services for older adults. Between August 2011 and May 2013, 136 individuals aged 60 and older participated in the program. Three case studies highlighting the psychosocial and physiological findings of participation in the program are presented. Preliminary data suggest that SMAs are an effective model of regularly screening at-risk older adults that augments primary care practice by facilitating early detection and referral for syndromes that may otherwise be missed or delayed. PMID:25440111

  7. [Successful aging: what can neurology and geriatrics contribute?].

    PubMed

    Synofzik, M; Maetzler, W

    2015-04-01

    The relative proportion of elderly persons in Western societies is rapidly growing, leading to an increasing frequency of age-related neurological diseases (e.g. dementia) and functional impairments (e.g. immobility). This article argues that this development should prompt a new focus in medical care. The key questions should not only be how can we improve treatment of age-related disorders but also how can we prevent age-related disorders in the first place or at least substantially delay their onset? These questions touch on an even more profound question: how can successful aging be accomplished? That is, which factors and processes characterize successful aging both on a system and on a molecular level? Thus, the crucial societal, scientific and medical challenges for Western societies are to develop and implement measures of primary prevention of dysfunctional aging. The disease-centered framework which currently determines most clinical thinking, scientific research and third party funding has to be supplemented by a novel framework of successful aging. This article defines dysfunctional aging as a convergent downstream result of multiple interacting system processes. Each of these detrimental system processes must be targeted by specific measures of geriatric primary prevention. This, in turn, implies that geriatrics does not start in the elderly or with the onset of particular geriatric disorders. Instead, it starts in the daily practice of neurology and other medical disciplines taking care of persons aged 20-40 years who are largely healthy and in the middle of their professional and personal career. Or, in a nutshell, geriatrics starts right in the middle of medical care. PMID:25801949

  8. Watching television in later life: a deeper understanding of TV viewing in the homes of old people and in geriatric care contexts.

    PubMed

    Ostlund, Britt

    2010-06-01

    A secret among staff at nursing homes is that they are often ambivalent about old residents spending more time in watching TV as it is a common cultural perception that it makes the viewer passive. The purpose of this paper is to highlight the importance of reflecting on the TV viewing habits that old people bring with them when they move into geriatric care. The findings are based on a study involving qualitative interviews and observations in two nursing home settings - urban and rural - of 20 persons between 82 and 100 years of age. The results confirm that TV viewing is far from a passive activity. Instead, it contributes to structuring daily life, to satisfying old peoples' needs for reflection and contemplation and to remain socially integrated. As such, TV viewing makes a significant contribution to their capacity to cope with disengagement in old age and can be used as a way of promoting communication and well-being in geriatric care. PMID:20030771

  9. Pre-Clerkship Observerships to Increase Early Exposure to Geriatric Medicine

    PubMed Central

    You, Peng; Leung, Marie; Xu, Victoria Y. Y.; Astell, Alexander; Gill, Sudeep S.; Gibson, Michelle; Frank, Christopher

    2015-01-01

    Background and Purpose To foster interest in geriatric care, the Queen’s Geriatrics Interest Group (QGIG) collaborated with the Division of Geriatric Medicine to arrange a Geriatrics Pre-Clerkship Observership Program. Methods Forty-two pre-clerkship medical students participated in the program between October 2013 and May 2014. Participants were paired with a resident and/or attending physician for a four-hour weekend observership on an inpatient geriatric rehabilitation unit. The program was assessed using: (1) internally developed Likert scales assessing student’s experiences and interest in geriatric medicine before and after the observership; (2) University of California Los Angeles–Geriatric Attitudes Scale (UCLA-GAS); and (3) narrative feedback. Results All participants found the process of setting up the observership easy. Some 72.7% described the observership experience as leading to positive changes in their attitude toward geriatric medicine and 54.5% felt that it stimulated their interest in the specialty. No statistically significant change in UCLA–GAS scores was detected (mean score pre- versus post-observership: 3.5 ± 0.5 versus 3.7 ± 0.4; p=.35). All participants agreed that the program should continue, and 90% stated that they would participate again. Conclusions The observership program was positively received by students. Structured pre-clerkship observerships may be a feasible method for increasing exposure to geriatric medicine. PMID:26740831

  10. New lessons of nurturing life for geriatric patients.

    PubMed

    Butler, James P; Fujii, Masahiko; Sasaki, Hidetada

    2012-01-01

    Our new lessons of nurturing life to make happiness and well-being of geriatric patients suggest comprise several important steps. First, geriatric patient care should not be delegated to specialists who focus on individual organ system. Instead, we should respond to the patient's condition based on comprehensive assessment to identify the single pathogenesis. Second, we should appreciate that the behavioral and psychological symptoms of dementia (BPSD) often reflect the behavioral and psychological symptoms of the caregiver (BPSC), and in particular the caregiver's attitude. Third, pleasant stimulations to the limbic system should receive more emphasis than attempting brain training in atrophied portions of the neocortex. Fourth, we should aim not for "successful aging," but for "balanced aging." Fifth, we should rely less on drug-based therapy and utilize more non-pharmacologic approaches to appropriate therapy. Geriatric patients should be cared for based on our new lessons of nurturing life rather than the heavily medicalized treatment modalities that are in wide use today. PMID:22790875

  11. The frailty syndrome: a critical issue in geriatric oncology.

    PubMed

    Ferrucci, Luigi; Guralnik, Jack M; Cavazzini, Chiara; Bandinelli, Stefania; Lauretani, Fulvio; Bartali, Benedetta; Repetto, Lazzaro; Longo, Dan L

    2003-05-01

    Evidence exists that the geriatric intervention guided by Comprehensive Geriatric Assessment (CGA) has positive effects on a number of important health outcomes in frail older patients. Although a number of observational studies, editorials, special articles and clinical reports, suggest that CGA should be used to guide the assessment and clinical decision-making in older cancer patients, there is limited support to this view in the literature. Older patients that are diagnosed with cancer are usually healthier and less problematic than persons of the same age who are randomly sampled from the general population. In these persons, the cancer dominates the clinical picture and, therefore, instruments especially tuned for the frail elderly may provide little information. The concept of the frailty syndrome, characterized by high susceptibility, low functional reserve and unstable homeostasis, has recently received a lot of attention by the geriatric community. A CGA approach, which also evaluates elements of the frailty syndrome, may be of great interest for those oncologists who want to identify older patients likely to develop severe toxicity and severe side effects in response to aggressive treatment. Improvements in the definition of the frailty syndrome may profit from the clinical experience of oncologists. PMID:12711358

  12. Venlafaxine-Induced Orthostatic Hypotension in a Geriatric Patient

    PubMed Central

    Chikkaramanjegowda, Vidyashree; de Leon, Jose

    2013-01-01

    Venlafaxine is not usually associated with risk of orthostatic hypotension. A 65-year-old US Caucasian female taking 225 mg/day of venlafaxine extended-release developed symptomatic orthostatic hypotension. The systolic and diastolic blood pressure dropped by 25 and 18 mm Hg, respectively, from supine position to standing position within 3 minutes. The patient was otherwise healthy and the orthostatic hypotension resolved with venlafaxine discontinuation. This was a probable venlafaxine adverse drug reaction according to the Naranjo scale. This case contributes to the scarce literature that indicates that clinicians need to be aware that occasionally venlafaxine can induce clinically significant orthostatic hypotension, particularly in geriatric patients. Our patient did not have orthostatic hypotension when she was taking venlafaxine at 60 years of age in higher venlafaxine doses (300 mg/day) but developed this adverse drug reaction when venlafaxine was restarted at the geriatric age. This case indicates that a history of prior tolerance to venlafaxine does not guarantee tolerance after 65 years of age. If a clinician decides to use venlafaxine in geriatric patients, the clinician should warn the patient about the risk of orthostatic hypotension and consider very slow titration and low doses. PMID:23984153

  13. Multidimensional Geriatric Prognostic Index, Based on a Geriatric Assessment, for Long-Term Survival in Older Adults in Korea.

    PubMed

    Jung, Hee-Won; Kim, Jin Won; Han, Ji Won; Kim, Kayoung; Kim, Jee Hyun; Kim, Kwang-Il; Kim, Cheol-Ho; Kim, Ki Woong

    2016-01-01

    The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI) for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA) and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH). The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1%) and 340 SNUBH patients (30.7%) died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital. PMID:26771562

  14. Multidimensional Geriatric Prognostic Index, Based on a Geriatric Assessment, for Long-Term Survival in Older Adults in Korea

    PubMed Central

    Jung, Hee-Won; Han, Ji Won; Kim, Kayoung; Kim, Jee Hyun; Kim, Kwang-Il; Kim, Cheol-Ho

    2016-01-01

    The patient´s survival estimate is important for clinical decision-making, especially in frail patients with multimorbidities. We aimed to develop a multidimensional geriatric prognosis index (GPI) for 3- and 5-year mortality in community-dwelling elderly and to validate the GPI in a separate hospital-based population. The GPI was constructed using data for 988 participants in the Korean Longitudinal Study on Health and Aging (KLoSHA) and cross-validated with 1109 patients who underwent a geriatric assessment at the Seoul National University Bundang Hospital (SNUBH). The GPI, with a total possible score of 8, included age, gender, activities of daily living, instrumental activities of daily living, comorbidities, mood, cognitive function, and nutritional status. During the 5-year observation period, 179 KLoSHA participants (18.1%) and 340 SNUBH patients (30.7%) died. The c-indices for 3- and 5-year mortality were 0.78 and 0.80, respectively, in the KLoSHA group and 0.73 and 0.80, respectively, in the SNUBH group. Positive linear trends were observed for GPI scores and both 3- and 5-year mortality in both groups. In conclusions, using common components of a geriatric assessment, the GPI can stratify the risk of 3- and 5-year mortality in Korean elderly people both in the community and hospital. PMID:26771562

  15. Nursing students identify fears regarding working with diverse critically ill patients: development of guidelines for caring for diverse critically ill older adults.

    PubMed

    Grossman, Sheila

    2013-01-01

    Undergraduate students need to gain more exposure to communicating, assessing, and planning appropriate care and evaluating outcomes of care with diverse critically ill geriatric patients. This project developed teaching strategies that facilitated additional opportunities for gaining these valuable learning experiences for students. Nurse educators can use the Guidelines for Caring for Diverse Critically Ill Older Adults, the case study and simulation examples, and topical outline to assist them in teaching critical care students and nurses about diverse critically ill older adults. PMID:23933642

  16. Perceived Barriers and Facilitators for Academic Career in Geriatrics: Medical Students’ Perspectives

    PubMed Central

    Curran, Maureen A.; Black, Michelle; Depp, Colin A.; Iglewicz, Alana; Reichstadt, Jennifer; Palinkas, Lawrence; Jeste, Dilip V.

    2014-01-01

    Objective There is a growing concern about a shortage of physician scientists. This problem is particularly severe in certain subspecialties such as geriatrics in general and geriatric psychiatry in particular. This study sought to obtain medical students’ perspectives on barriers and facilitators toward pursuing a career in academics and/or in geriatric psychiatry or medicine. Methods The study surveyed 27 first-year medical students from six US medical schools, who had demonstrated a clear interest in academic geriatrics by completing a mentored summer research training program in geriatric medicine or geriatric psychiatry, funded by the National Institute on Aging. The survey included open-ended and close-ended questions about likely career choice and factors affecting it. Results Sixty percent of students reported they were likely to pursue an academic career, 44% a career in geriatric psychiatry or medicine, and only 36% a career in academic geriatrics. The most frequently perceived barriers were a lack of knowledge about academic careers and lack of exposure to geriatrics, financial concerns due to loan debts and low compensation, and negative impressions of research and of working with older adults. Facilitators included positive experiences with or positive impressions of research and research mentors and of older adults, and the growing demand for geriatric care. Conclusions Attracting capable and motivated medical students to academic careers in fields such as geriatric psychiatry or medicine should be a priority in seeking to expand the numbers of physician scientists and to add to the healthcare workforce in underserved subspecialty areas. Necessary approaches should include opportunities to work in academic settings, availability of sustained and dedicated mentorship, early, consistent, and positive exposure to older adults, and financial incentives. PMID:25080223

  17. The interprofessional clinical experience: interprofessional education in the nursing home.

    PubMed

    Sheppard, Kendra D; Ford, Channing R; Sawyer, Patricia; Foley, Kathleen T; Harada, Caroline N; Brown, Cynthia J; Ritchie, Christine S

    2015-03-01

    The interprofessional clinical experience (ICE) was designed to introduce trainees to the roles of different healthcare professionals, provide an opportunity to participate in an interprofessional team, and familiarize trainees with caring for older adults in the nursing home setting. Healthcare trainees from seven professions (dentistry, medicine, nursing, nutrition, occupational therapy, optometry and social work) participated in ICE. This program consisted of individual patient interviews followed by a team meeting to develop a comprehensive care plan. To evaluate the impact of ICE on attitudinal change, the UCLA Geriatric Attitudes Scale and a post-experience assessment were used. The post-experience assessment evaluated the trainees' perception of potential team members' roles and attitudes about interprofessional team care of the older adult. Attitudes toward interprofessional teamwork and the older adult were generally positive. ICE is a novel program that allows trainees across healthcare professions to experience interprofessional teamwork in the nursing home setting. PMID:25140581

  18. A staff management system for maintaining improvements in continence with elderly nursing home residents.

    PubMed Central

    Burgio, L D; Engel, B T; Hawkins, A; McCormick, K; Scheve, A; Jones, L T

    1990-01-01

    We developed a staff management system for maintaining treatment gains achieved on a specialized continence unit located in a geriatric nursing home. Geriatric assistants learned to use a prompted voiding procedure to maintain improved dryness for 4 elderly residents. The staff management system included self-monitoring and recording of prompted voiding activities and supervisory monitoring and feedback based on group performance of these activities. Results show that the system was effective in maintaining prompted voiding activities with corresponding maintenance of improved patient continence. However, a gradual decline in staff performance was noted 4 to 5 months after the initiation of the system. During a subsequent phase of the study, provision of individual feedback restored staff performance to previous levels. Results are discussed in relation to the practicality of prompted voiding interventions in nursing home environments and the applicability of staff management systems in this setting. PMID:2335482

  19. 77 FR 49865 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-17

    ...), Veterans Health Administration (VHA) strategic planning activities in geriatrics and extended care, recent... of Veterans Affairs and the Under Secretary for Health on all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities and programs to meet...

  20. The Glass Is Half Full: Geriatric Precepting Encounters in Family Medicine

    ERIC Educational Resources Information Center

    Rollins, Lisa K.; Martirosian, Tovia; Gazewood, John D.

    2009-01-01

    Approximately 19% to 20% of all family medicine office visits involve care to patients older than age 65, yet limited research addresses family medicine geriatric education in the outpatient setting. This study explored how geriatric content is incorporated into resident/attending precepting encounters, using direct observation. An observer…

  1. Strengthening Geriatric Knowledge and Use of Interdisciplinary Teams among Allied Health Students and Practitioners.

    ERIC Educational Resources Information Center

    Schrader, Susan L.; Blue, Rebecca; Miller, Doreen; Jensen, Gwenneth; Zawada, Edward T., Jr.; Hill, Paula; Johannsen, Gail; Elsberry, Dorothy Anne; Nelson, Debralee; Lockwood, Dean

    1999-01-01

    In a three-year collaborative venture between a hospital and a university, an interdisciplinary team trained 684 allied health professionals and students in geriatrics. Outcomes included increased geriatric knowledge, more graduates serving rural underserved areas, and more interdisciplinary clinical initiatives. (SK)

  2. First Year Medical Students' Knowledge, Attitudes, and Interest in Geriatric Medicine

    ERIC Educational Resources Information Center

    Lu, Wei-Hsin; Hoffman, Kimberly G.; Hosokawa, Michael C.; Gray, M. Peggy; Zweig, Steven C.

    2010-01-01

    The purpose of this study was to examine the impact of an extracurricular geriatric program on medical students' knowledge of, and attitudes toward, the elderly and their interest in studying geriatric medicine. The participants were first-year medical students (n = 137) who joined the Senior Teacher Education Partnership (STEP) program that…

  3. [Benefit of a geriatric mobile team in the emergency departments: a ten-year review].

    PubMed

    Natali, Jean-Philippe; Schwald, Nathalie; Bach, Frédérique; Bourgouin, Gaëlle; Chiffray, Dominique; Bloch, Frédéric

    2015-01-01

    geriatric mobile team was created in the emergency department of Cochin Hospital in Paris, in 2005. This key player in the multi-disciplinary management of elderly patients in the emergency department and in the geriatric care pathway, showed, during its 10-year of existence, its utility. PMID:26574128

  4. Mortality of Geriatric and Younger Patients with Schizophrenia in the Community

    ERIC Educational Resources Information Center

    Ran, Mao-Sheng; Chan, Cecilia Lai-Wan; Chen, Eric Yu-Hai; Tang, Cui-Ping; Lin, Fu-Rong; Li, Li; Li, Si-Gan; Mao, Wen-Jun; Hu, Shi-Hui; Schwab, Gerhard; Conwell, Yeates

    2008-01-01

    Little is known about the differences in mortality among non-institutionalized geriatric and younger patients with schizophrenia. In this study long-term mortality and suicidal behavior of all the geriatric (age greater than or equal to 65 years), middle-age (age 41-64 years), and young (age 15-40 years) subjects with schizophrenia living in a…

  5. Basic Geriatrics Knowledge Among Internal Medicine Trainees in a Teaching Hospital in Saudi Arabia.

    PubMed

    Al-Aama, Tareef

    2016-06-01

    To assess the basic knowledge of medical trainees, in the absence of a structured geriatrics curriculum, around a variety of geriatric medicine components that are considered essential for the care of the rapidly increasing elderly population. Eighty-three trainees at different levels of training in internal medicine were asked about a variety of common geriatric conditions. Those included: delirium, falls, geriatric syndromes, pain, cognitive impairment, and medications. The trainees' knowledge about common geriatric condition was overall poor. The most pronounced deficits included: the lack of familiarity in diagnosing geriatric syndromes (63 %) or managing them (67 %), the underestimation of the prevalence of delirium (49 %), and the tendency to undertreat pain (64 %). Poor familiarity with polypharmacy and its impact, as well as inappropriate prescription practices in the elderly were also observed. In the absence of a structured geriatric medicine curriculum, internal medicine trainees' knowledge about important geriatric conditions is poor, even if their internal medicine knowledge is overall adequate. This would translate into suboptimal care for this vulnerable and rapidly expanding segment of the population. PMID:27033085

  6. Geriatric Expertise among Medical School Faculty: Preparing for the Challenges of an Aging Population

    ERIC Educational Resources Information Center

    Laditka, Sarah B.; Jenkins, Carol L.; Eleazer, G. Paul; Kelsey, Susan G.

    2007-01-01

    This study examined non-geriatrician physicians' experiences in a geriatrics-focused faculty development program, and effects of the program on their geriatrics knowledge and their teaching and practice. In-depth interviews were conducted with all physicians (n = 26) participating in the Dean's Faculty Scholars in Aging program. Most participants…

  7. Physician Assistant Attitude and Expressed Intent to Work with Geriatric Patients

    ERIC Educational Resources Information Center

    Woolsey, Lisa J.

    2007-01-01

    This study evaluated the attitudes of physician assistant students (PAS) and practicing physician assistants (PA) toward geriatric patients and the expressed intent of PAS and practicing PAs toward practicing in the specialized field of geriatric medicine using a cross-sectional study design. The 233 participants each completed a questionnaire…

  8. Integrating Geriatrics into Medical School: Student Journaling as an Innovative Strategy for Evaluating Curriculum

    ERIC Educational Resources Information Center

    Shield, Renee R.; Farrell, Timothy W.; Nanda, Aman; Campbell, Susan E.; Wetle, Terrie

    2012-01-01

    Purpose of the study: The Alpert Medical School of Brown University began to integrate geriatrics content into all preclerkship courses and key clerkship cases as part of a major medical school curriculum redesign in 2006. This study evaluates students' responses to geriatrics integration within the curriculum using journals kept by volunteer…

  9. The Brave New World of GEC Evaluation: The Experience of the Rhode Island Geriatric Education Center

    ERIC Educational Resources Information Center

    Filinson, Rachel; Clark, Phillip G.; Evans, Joann; Padula, Cynthia; Willey, Cynthia

    2012-01-01

    In 2007, the Health Resources Services Administration introduced new mandates that raised the standards on program evaluation for Geriatric Education Centers. Described in this article are the primary and secondary evaluation efforts undertaken for one program within the Rhode Island Geriatric Education Center (RIGEC), the findings from these…

  10. Specialist Physicians in Geriatrics—Report of the Canadian Geriatrics Society Physician Resource Work Group*

    PubMed Central

    Hogan, David B.; Borrie, Michael; Basran, Jenny F.S.; Chung, A. Maria; Jarrett, Pamela G.; Morais, José A.; Peters, Eileen; Rockwood, Kenneth J.; St. John, Philip D.; Sclater, Anne L.; Stultz, Timothy; Woolmore-Goodwin, Sarah

    2012-01-01

    Background At the 2011 Annual Business Meeting of the Canadian Geriatrics Society (CGS), an ad hoc Work Group was struck to submit a report providing an estimate of the number of physicians and full-time equivalents (FTEs) currently working in the field of geriatrics, an estimate of the number required (if possible), and a clearer understanding of what has to be done to move physician resource planning in geriatrics forward in Canada. Methods It was decided to focus on specialist physicians in geriatrics (defined as those who have completed advanced clinical training or have equivalent work experience in geriatrics and who limit a significant portion of their work-related activities to the duties of a consultant). Results In 2012, there are 230–242 certified specialists in geriatric medicine and approximately 326.15 FTE functional specialists in geriatrics. While this is less than the number required, no precise estimate of present and future need could be provided, as no attempts at a national physician resource plan in geriatrics based on utilization and demand forecasting, needs-based planning, and/or benchmarking have taken place. Conclusions This would be an opportune time for the CGS to become more involved in physician resource planning. In addition to this being critical for the future health of our field of practice, there is increasing interest in aligning specialty training with societal needs (n = 216). PMID:23259019

  11. Cognitive Deficits in Geriatric Depression: Clinical Correlates and Implications for Current and Future Treatment

    PubMed Central

    Morimoto, Sarah Shizuko; Alexopoulos, George S.

    2013-01-01

    Synopsis The purpose of this article is to identify the cognitive deficits commonly associated with geriatric depression, and describe their clinical significance. We then summarize the complex relationship between geriatric depression and dementia and discuss possible shared mechanisms. Last, we present evidence regarding whether the cognitive deficits in depression may be mitigated with medication or with computerized cognitive remediation. PMID:24229654

  12. Health Care Workforce Development in Rural America: When Geriatrics Expertise Is 100 Miles Away

    ERIC Educational Resources Information Center

    Tumosa, Nina; Horvath, Kathy J.; Huh, Terri; Livote, Elayne E.; Howe, Judith L.; Jones, Lauren Ila; Kramer, B. Josea

    2012-01-01

    The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

  13. Some of My Best Friends Are Old: A Qualitative Exploration of Medical Students' Interest in Geriatrics

    ERIC Educational Resources Information Center

    Schigelone, Amy Schiller; Ingersoll-Dayton, Berit

    2004-01-01

    This paper provides insight into the reasons underlying medical students' interest in geriatrics. Semi-structured interviews, informed by attitude theory, were conducted with first-year medical students who indicated that they were not interested in geriatric medicine and those who indicated that they were moderately to very interested in…

  14. Some of My Best Friends Are Old: A Qualitative Exploration of Medical Students' Interest in Geriatrics

    ERIC Educational Resources Information Center

    Schigelone, Amy Schiller; Ingersoll-Dayton, Berit

    2004-01-01

    This paper provides insight into the reasons underlying medical students' interest in geriatrics. Semi-structured interviews, informed by attitude theory, were conducted with first-year medical students who indicated that they were not interested in geriatric medicine ( n =10) and those who indicated that they were moderately to very interested in…

  15. 76 FR 17999 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-03-31

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee; Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee...

  16. 75 FR 54232 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-03

    ... program advances in palliative care, and performance and oversight of the VA Geriatric Research, Education... gerontology. The Committee assesses the capability of VA health care facilities and programs to meet the... discussions on VA's geriatrics and extended care programs, aging research activities, update on VA's...

  17. A Community-Based Approach for Integrating Geriatrics and Gerontology into Undergraduate Medical Education

    ERIC Educational Resources Information Center

    Martinez, Iveris L.; Mora, Jorge Camilo

    2012-01-01

    Medical school accreditation requirements require educational opportunities in geriatrics. Twenty-six minimum graduating competencies in geriatrics have recently been identified for medical students. The authors describe how these competencies are being integrated into a new medical curriculum through coursework and community-based experiences.…

  18. Impairment in Instrumental Activities of Daily Living and the Geriatric Syndrome of Self-Neglect

    ERIC Educational Resources Information Center

    Naik, Aanand D.; Burnett, Jason; Pickens-Pace, Sabrina; Dyer, Carmel B.

    2008-01-01

    Purpose: We sought to characterize self-neglect definitively as a geriatric syndrome by identifying an association with functional impairment. Design and Methods: We performed a cross-sectional home evaluation of 100 community-living older adults referred by Adult Protective Services for geriatric self-neglect and 100 matched adults from a…

  19. Geriatric Medicine Fellows' Experiences and Attitudes toward an Objective Structured Clinical Examination (OSCE)

    ERIC Educational Resources Information Center

    Bagri, Anita S.; Zaw, Khin M.; Milanez, Marcos N.; Palacios, Juan J.; Qadri, Syeda S.; Bliss, Linda A.; Roos, Bernard A.; Ruiz, Jorge G.

    2009-01-01

    A total of 8 geriatric medicine fellows participated in an objective structured clinical examination (OSCE) assessing communication skills and clinical reasoning in common geriatric syndromes. To determine their perceptions about the experience, we conducted surveys and semistructured interviews. We analyzed the survey data using descriptive…

  20. [Geriatric rehabilitation from the perspective of Book 9 of the German social code, SGB IX].

    PubMed

    Fuchs, H

    2007-10-01

    The legal foundations for provision and realization of geriatric rehabilitation benefits are contained in particular in Book 9 of the German social code, SGB IX (covering rehabilitation and participation of people with disabilities). This paper discusses claims foundations and benefit prerequisites of geriatric rehabilitation taking into consideration the relations between Book 5 (on health insurance) and Book 9 of the social code. The article includes a definition of "geriatric rehabilitation" in light of the SGB IX, describes the benefit carriers' obligations as well as the procedure in place for determining geriatric rehab need, in this context appraising the designation as "geriatric patient" in terms of its appropriateness as an identifying criterion in determining need. Provision of geriatric rehab benefits is contingent on a potential for attaining rehab goals as specified by SGB IX as well as on fulfillment of the benefit prerequisites. Responsibility for the content, extent and quality of geriatric rehabilitation lies with the benefit carriers, as is the case for the obligation to secure availability of the required numbers and quality of rehabilitation facilities and services. The article specifies the legal foundations of the various benefit types (ambulatory, mobile rehab, under a Personal Budget, integrated benefit provision, or early rehab), and discusses geriatric rehabilitation in the framework of an insurance-based medical care system as well as of activating care. PMID:17955397

  1. California Geriatric Education Center Logic Model: An Evaluation and Communication Tool

    ERIC Educational Resources Information Center

    Price, Rachel M.; Alkema, Gretchen E.; Frank, Janet C.

    2009-01-01

    A logic model is a communications tool that graphically represents a program's resources, activities, priority target audiences for change, and the anticipated outcomes. This article describes the logic model development process undertaken by the California Geriatric Education Center in spring 2008. The CGEC is one of 48 Geriatric Education…

  2. Relating Medical Students' Knowledge, Attitudes, and Experience to an Interest in Geriatric Medicine

    ERIC Educational Resources Information Center

    Fitzgerald, James T.; Wray, Linda A.; Halter, Jeffrey B.; Williams, Brent C.; Supiano, Mark A.

    2003-01-01

    Purpose: This study examined medical students' interest in geriatrics: Are knowledge, positive attitudes, and prior experience with older adults associated with an interest in geriatric medicine? Design and Methods: Entering University of Michigan medical students completed three surveys: the Revised Facts on Aging Quiz, the University of…

  3. Successful Implementation of a Faculty Development Program in Geriatrics for Non-Primary Care Physician Educators

    ERIC Educational Resources Information Center

    Williams, Brent C.; Schigelone, Amy R.; Fitzgerald, James T.; Halter, Jeffrey B.

    2008-01-01

    A four-year faculty development program to enhance geriatrics learning among house officers in seven surgical and related disciplines and five medical subspecialties at a large academic institution resulted in changes in attitudes and knowledge of faculty participants, expanded curricula and teaching activities in geriatrics, and enhanced and…

  4. 77 FR 14860 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-03-13

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS Geriatrics and Gerontology Advisory Committee, Notice of Meeting The Department of Veterans Affairs (VA) gives notice under Public Law 92-463 (Federal Advisory Committee Act) that a meeting of the Geriatrics and Gerontology Advisory Committee...

  5. An Outcome Evaluation of Reality Orientation Therapy with Geriatric Patients in a State Mental Hospital

    ERIC Educational Resources Information Center

    Harris, Clarke S.; Ivory, Peter B. C. B.

    1976-01-01

    Reality Orientation (RO) Therapy, a recently developed mode of treatment for use with geriatric patients was discussed. A controlled study was conducted comparing the effects of RO with those of traditional hospital care. The results indicated that RO is a promising technique for use with a chronic geriatric patient population. (Author)

  6. Community Psychiatrists Who See Geriatric Patients: What's Training Got to Do with It?

    ERIC Educational Resources Information Center

    Lieff, Susan; Andrew, Melissa; Tiberius, Richard

    2004-01-01

    Objective: This study examines the issues influencing psychiatrists' decisions to provide care to the under-served geriatric population. Methods: Community-based psychiatrists who see geriatric patients participated in focus group discussions exploring factors that influence the characteristics of their current practices. Results: Personal themes,…

  7. A Conceptual Framework for Teaching Geriatrics in a Family Medicine Residency.

    ERIC Educational Resources Information Center

    Moore, James T.; Bobula, James A.

    1980-01-01

    A competency-based curriculum model for teaching geriatrics in a family medicine residency is described that divides competencies under four major goals: understanding principles, obtaining and interpreting data, managing geriatric patients, and working in a health care team. Sample objectives, instructional methods, and student evaluation are…

  8. Assessment of the geriatric competence and perceived needs of Italian nephrologists: an internet survey.

    PubMed

    Aucella, Filippo; Brunori, Giuliano; Dalmartello, Michela; Leosco, Dario; Paolisso, Giuseppe; Marangella, Martino; Capasso, Giovanni Battista; Antonelli Incalzi, Raffaele

    2016-06-01

    An internet survey was set up to assess the geriatric competence and perceived needs of 337 members of the Italian society of nephrology (SIN). The survey assessed how well aware nephrologists are of the typical geriatric conditions and needs of their elderly chronic kidney disease (CKD) patients. SIN associates were also questioned about their current use of comprehensive geriatric assessment, prescription of potentially nephrotoxic drugs, and screening for osteoporosis. The main finding is that CKD and dialysis are almost unanimously perceived as typically geriatric conditions, but knowledge and use of geriatric tools are scanty. While use of potentially inappropriate drugs is rare, almost half of the patients are not screened for osteoporosis. The significant clinical gaps observed could greatly impair the management of older CKD patients, and call for an urgent educational intervention. PMID:26385799

  9. Structures and geriatrics from a failure analysis experience viewpoint

    SciTech Connect

    Hopper, D.M. )

    1993-05-01

    In a failure analysis consulting engineering practice one sees a variety of structural failures from which observations may be made concerning geriatric structures. Representative experience with power plants, refineries, offshore structures, and forensic investigations is summarized and generic observations are made regarding the maintenance of fitness for purpose of structures. Although it is important to optimize the engineering design for a range of operational and environmental variables, it is essential that fabrication and inspection controls exist along with common sense based ongoing monitoring and operations procedures. 18 figs.

  10. Health care: economic impact of caring for geriatric patients.

    PubMed

    Rich, Preston B; Adams, Sasha D

    2015-02-01

    National health care expenditures constitute a continuously expanding component of the US economy. Health care resources are distributed unequally among the population, and geriatric patients are disproportionately represented. Characterizing this group of individuals that accounts for the largest percentage of US health spending may facilitate the introduction of targeted interventions in key high-impact areas. Changing demographics, an increasing incidence of chronic disease and progressive disability, rapid technological advances, and systemic market failures in the health care sector combine to drive cost. A multidisciplinary approach will become increasingly necessary to balance the delicate relationship between our constrained supply and increasing demand. PMID:25459539

  11. [Geriatric patients with chronic kidney insufficiency: which antalgia?].

    PubMed

    Ionescu, M; Hemett, O M; Descombes, E; Blondel, N; Hayoz, D

    2014-04-01

    Pain is a leading cause of office visits. In the geriatric population, it is known that the prevalence of renal failure increases exponentially with age, modifing the elimination of drugs and of their metabolites. What analgesia should be offered to these patients? The holy grail would be a medication without renal elimination, without toxic metabolites and without nephrotoxicity. Based on the literature we try to propose a specific approach to analgesia in older patients with kidney insufficiency, in order to help practitioners to better prescribe for this group of patients. PMID:24791426

  12. Cognitive Aging: What Every Geriatric Psychiatrist Should Know.

    PubMed

    Blazer, Dan G; Wallace, Robert B

    2016-09-01

    The authors of this review both served on the Institute of Medicine Committee, which produced the report "Cognitive Aging: Progress in Understanding and Opportunities for Action." In this review, the authors summarize portions of the report that are especially applicable to geriatric psychiatrists and other clinicians who work with the elderly. Cognitive aging is a universal phenomenon that must be better understood by clinicians, a trajectory across multiple cognitive functions upstream from mild neurocognitive and major neurocognitive disorders. The authors review the epidemiology, basic neurobiology, and evidence-based interventions for cognitive aging. PMID:27569270

  13. Absence of Streptococcus pneumoniae in pharyngeal swabs of geriatric inpatients.

    PubMed

    Jomrich, Nina; Kellner, Silvia; Djukic, Marija; Eiffert, Helmut; Nau, Roland

    2015-07-01

    Colonization of the pharynx by Streptococcus pneumoniae was studied in 185 in-hospital geriatric patients (median age 81 years) from 29 March 2011 to 22 June 2011. Swabs were plated on blood agar plates. Colonies with a morphology suggesting S. pneumoniae were further analyzed. Surprisingly, pneumococci were not found in any of the samples. Pneumococci chronically colonizing the pharynx of elderly people may be much rarer than previously thought and probably are not the source of pneumococcal pneumonia in old age. PMID:25746605

  14. Integrating geriatrics into clinical training, research training, board certification, and continuing education in infectious diseases: meeting review and commentary.

    PubMed

    High, K P; Joiner, K A

    1999-04-01

    Although adults aged 65 years and older constitute the most rapidly growing segment of the U.S. population, geriatric issues have not typically been a focus of training in infectious diseases (ID). Underrecognition of the unique aspects of geriatric care, apathy toward this population, and the feeling that "we're all geriatricians" (and thus know geriatric medicine) all contribute to this problem. This article summarizes the recent meeting focused on integrating geriatric principles within ID training at all levels. The ID/geriatric interface as an attractive area for basic and clinical research is emphasized. PMID:10825033

  15. Estimating Geriatric Mortality after Injury Using Age, Injury Severity, and Performance of a Transfusion: The Geriatric Trauma Outcome Score

    PubMed Central

    Zhao, Frank Z.; Wolf, Steven E.; Nakonezny, Paul A.; Minhajuddin, Abu; Rhodes, Ramona L.; Paulk, M. Elizabeth

    2015-01-01

    Abstract Background: A tool to determine the probability of mortality for severely injured geriatric patients is needed. Objective: We sought to create an easily calculated geriatric trauma prognostic score based on parameters available at the bedside to aid in mortality probability determination. Methods: All patients ≥65 years of age were identified from our Level I trauma center's registry between January 1, 2000 and December 31, 2013. Measurements included age, Injury Severity score (ISS), units of packed red blood cells (PRBCs) transfused in the first 24 hours, and patients' mortality status at the end of their index hospitalization. As a first step, a logistic regression model with maximum likelihood estimation and robust standard errors was used to estimate the odds of mortality from age, ISS, and PRBCs after dichotomizing PRBCs as yes/no. We then constructed a Geriatric Trauma Outcome (GTO) score that became the sole predictor in the re-specified logistic regression model. Results: The sample (n=3841) mean age was 76.5±8.1 years and the mean ISS was 12.4±9.8. In-hospital mortality was 10.8%, and 11.9% received a transfusion by 24 hours. Based on the logistic regression model, the equation with the highest discriminatory ability to estimate probability of mortality was GTO Score=age+(2.5×ISS)+22 (if given PRBCs). The area under the receiver operating characteristic curve (AUC) for this model was 0.82. Selected GTO scores and their related probability of dying were: 205=75%, 233=90%, 252=95%, 310=99%. The range of GTO scores was 67.5 (survivor) to 275.1 (died). Conclusion: The GTO model accurately estimates the probability of dying, and can be calculated at bedside by those possessing a working knowledge of ISS calculation. PMID:25974408

  16. American Geriatrics Society care of lesbian, gay, bisexual, and transgender older adults position statement: American Geriatrics Society Ethics Committee.

    PubMed

    2015-03-01

    There is ample evidence that lesbian, gay, bisexual, and transgender (LGBT) individuals face discrimination in the healthcare setting. Providing high-quality health care for older LGBT adults will require active steps by organizations, institutions, advocacy groups, and health professionals that create an environment that is free from discrimination. This position statement that the American Geriatrics Society (AGS) Ethics Committee developed addresses the vision of the AGS for the care of LGBT older adults and specific steps that can be taken to ensure that they receive the care that they need. PMID:25803784

  17. The National Hartford Center of Gerontological Nursing Excellence: An Evolution of a Nursing Initiative to Improve Care of Older Adults.

    PubMed

    Harden, J Taylor; Watman, Rachael A

    2015-06-01

    The mission of the John A. Hartford Foundation is to improve the health of older Americans. This mission has been realized throughout the evolution of the National Hartford Center of Gerontological Nursing Excellence-an international collaboration between Schools of Nursing and Sigma Theta Tau International Honor Society of Nursing-whose goal is to support research, education, and practice to provide better nursing care for our aging society. The National Hartford Center is the focus of this supplement and an example of the Foundation's grant-making to prepare the nursing workforce to be competent to care for our aging society. This article traces the innovative origin and inception of the National Hartford Center, first as the Building Academic Geriatric Nursing Capacity (BAGNC) Initiative in 2000 under the leadership of two groundbreaking scholars in nursing and aging sciences: Claire M. Fagin, PhD, RN, and Patricia G. Archbold, DNSc. We continue through to today's leadership and culminate by describing the Center's influence on the gerontological nursing workforce and clinical practice; the paper also includes a brief introduction to the articles, highlighting advances in gerontological nursing science. With funding from the John A. Hartford Foundation, The Atlantic Philanthropies, The Mayday Fund, and a number of creative public and nonprofit partnerships, the National Hartford Center celebrates two decades and its greatest asset-the nearly 300 gerontological nursing leaders, including Archbold nursing pre-docs, Fagin nursing post-docs, and expert faculty, along with its Hartford Centers of Gerontological Nursing Excellence across the country. We trace the transition of BAGNC to the membership-based National Hartford Center and its move to The Gerontological Society of America to become a self-sustaining, autonomous unit. Current needs, challenges, lessons learned, and strategies of the National Hartford Center are examined within the context of sustainability

  18. Integrating behavior change theory into geriatric case management practice.

    PubMed

    Enguidanos, S

    2001-01-01

    Case management practices have continued to grow despite a lack of clear evidence of their efficacy. With the expanding segment of the elderly population, there is a critical need to develop and identify programs that will address the many needs of the aging. Geriatric Case Management has been the avenue selected by many health care providers to address these issues, focusing on maintaining health status and improving linkages with medical and community resources. Studies testing the effectiveness of these models have failed to demonstrate their effectiveness in reducing depression, reducing acute care service use, and improving or maintaining health status. The Geriatric Case Management models presented in these lack an evidence-based, theoretical framework that provides definition and direction for case management practice. This article introduces behavior change theories as a method of structuring and delineating the case management intervention. The Transtheoretical Model and the Theory of Planned Behavior are discussed and methods of integrating these theories into practice are discussed. PMID:11878076

  19. Clinical preference for factors in treatment of geriatric depression

    PubMed Central

    Riepe, Matthias W

    2015-01-01

    Little is known about symptom preferences of clinical psychiatrists in the treatment of geriatric depression and preferences for avoiding adverse drug effects. Participants (board-certified psychiatrists) were recruited prior to a lecture on geriatric depression during a continuing education program. An analytic hierarchy process was performed and participants were asked for pairwise comparison of criteria guiding them in appraising therapeutic efficacy, and in avoiding toxicity and adverse events. Of the 61 participants from the continuing education program, 42 (69%) returned their data sheet. Avoidance of cardiotoxicity was regarded as more important than avoidance of hepatotoxicity or hematotoxicity. Concerning adverse events, highest preference was given to avoidance of falls and drug interactions, followed by avoidance of sedation, weight change, and impairment of sexual function. The most important preferences for appraisal of therapeutic efficacy were suicidality over ability to concentrate and sleep. Clinical psychiatrists have a hierarchy of preferences for treatment goals and avoidance of adverse events and toxicity. This raises the question for future research whether these preferences cause differences in prescription patterns in clinical practice even though a multitude of antidepressants are similarly effective when judged with instruments used in clinical trials. PMID:25565848

  20. Incontinence-associated dermatitis and pressure ulcers in geriatric patients.

    PubMed

    Kottner, J; Beeckman, D

    2015-12-01

    The key characteristics of geriatric patients are advanced age, multimorbidity, a decrease of psychical performance and care dependency. In addition, advanced age, chronic and acute diseases and treatments (e.g. polypharmacy) lead, either directly or indirectly, to a wide range of skin and tissue problems. Incontinence-associated dermatitis and pressure ulcers (PUs) belong to the most prevalent in geriatric settings. Prolonged exposure of the skin to urine and/or stool can cause an irritant contact dermatitis. Skin surface 'wetness', increased skin surface pH, digestive intestinal enzymes, repeated skin cleansing activities, and a possible occlusive environment contribute to irritation and inflammation. Prevention and treatment includes activities to maintain and to enhance continence and to limit, to reduce exposure of the skin to urine and stool, and to promote healing and reepithelialisation. In frail aged skin, it is recommended to use incontinence products with smooth and breathable materials with maximum absorption capacity. Immediate skin cleansing after soiling using mild cleansers and protective and caring leave-on products are recommended. PUs are localized injuries to the skin and/or underlying tissue caused by sustained deformations of skin and underlying soft tissues. PUs management includes risk assessment, repositioning and mobilization, and the use of appropriate support surfaces. Patients must be never positioned directly on an existing PU. Especially at end of life, the PU closure and wound healing may not be the primary therapeutic goal. PMID:26186379

  1. Antimicrobial Stewardship for a Geriatric Behavioral Health Population

    PubMed Central

    Ellis, Kristen; Rubal-Peace, Georgina; Chang, Victoria; Liang, Eva; Wong, Nicolas; Campbell, Stephanie

    2016-01-01

    Antimicrobial resistance is a growing public health concern. Antimicrobial stewardship and multi-disciplinary intervention can prevent inappropriate antimicrobial use and improve patient care. Special populations, especially older adults and patients with mental health disorders, can be particularly in need of such intervention. The purpose of this project was to assess the impact of pharmacist intervention on appropriateness of antimicrobial prescribing on a geriatric psychiatric unit (GPU). Patients ≥18 years old prescribed oral antibiotics during GPU admission were included. Antimicrobial appropriateness was assessed pre- and post-pharmacist intervention. During the six-month pre- and post-intervention phase, 63 and 70 patients prescribed antibiotics were identified, respectively. Subjects in the post-intervention group had significantly less inappropriate doses for indication compared to the pre-intervention group (10.6% vs. 23.9%, p = 0.02), and significantly less antibiotics prescribed for an inappropriate duration (15.8% vs. 32.4%, p < 0.01). There were no significant differences for use of appropriate drug for indication or appropriate dose for renal function between groups. Significantly more patients in the post intervention group had medications prescribed with appropriate dose, duration, and indication (51% vs. 66%, p = 0.04). Pharmacist intervention was associated with decreased rates of inappropriate antimicrobial prescribing on a geriatric psychiatric unit. PMID:27025523

  2. Chronic diseases in captive geriatric female Chimpanzees (Pan troglodytes).

    PubMed

    Nunamaker, Elizabeth A; Lee, D Rick; Lammey, Michael L

    2012-04-01

    The current aging population of captive chimpanzees is expected to develop age-related diseases and present new challenges to providing their veterinary care. Spontaneous heart disease and sudden cardiac death are the main causes of death in chimpanzees (especially of male animals), but little is known about the relative frequency of other chronic diseases. Furthermore, female chimpanzees appear to outlive the males and scant literature addresses clinical conditions that affect female chimpanzees. Here we characterize the types and prevalence of chronic disease seen in geriatric (older than 35 y) female chimpanzees in the colony at Alamogordo Primate Facility. Of the 16 female chimpanzees that fit the age category, 87.5% had some form of chronic age-related disease. Cardiovascular-related disease was the most common (81.25%) followed by metabolic syndrome (43.75%) and renal disease (31.25%). These data show the incidence of disease in geriatric female chimpanzees and predict likely medical management challenges associated with maintaining an aging chimpanzee population. PMID:22546920

  3. A randomised clinical trial on a comprehensive geriatric assessment and intensive home follow-up after hospital discharge: the Transitional Care Bridge

    PubMed Central

    2010-01-01

    Background Older patients are at high risk for poor outcomes after acute hospital admission. The mortality rate in these patients is approximately 20%, whereas 30% of the survivors decline in their level of activities of daily living (ADL) functioning three months after hospital discharge. Most diseases and geriatric conditions that contribute to poor outcomes could be subject to pro-active intervention; not only during hospitalization, but also after discharge. This paper presents the design of a randomised controlled clinical trial concerning the effect of a pro-active, multi-component, nurse-led transitional care program following patients for six months after hospital admission. Methods/Design Three hospitals in the Netherlands will participate in the multi-centre, double-blind, randomised clinical trial comparing a pro-active multi-component nurse-led transitional care program to usual care after discharge. All patients acutely admitted to the Department of Internal Medicine who are 65 years and older, hospitalised for at least 48 hours and are at risk for functional decline are invited to participate in the study. All patients will receive integrated geriatric care by a geriatric consultation team during hospital admission. Randomization, which will be stratified by study site and cognitive impairment, will be conducted during admission. The intervention group will receive the transitional care bridge program, consisting of a handover moment with a community care Care Nurse (CN) during hospital admission and five home visits after discharge. The control group will receive 'care as usual' after discharge. The main outcome is the level of ADL functioning six months after discharge compared to premorbid functioning measured with the Katz ADL index. Secondary outcomes include; survival, cognitive functioning, quality of life, and health care utilization, satisfaction of the patient and primary care giver with the transitional care bridge program. All outcomes

  4. The Effectiveness of a Geriatric Hip Fracture Clinical Pathway in Reducing Hospital and Rehabilitation Length of Stay and Improving Short-Term Mortality Rates

    PubMed Central

    Lau, Tak-Wing; Fang, Christian; Leung, Frankie

    2013-01-01

    Background: A geriatric hip fracture clinical pathway, led by an orthopedic surgeon, was developed in 2007. This clinical pathway team is multidisciplinary and consists of surgeons, physicians, anesthetists, nurses, physiotherapists, occupational therapists, medical social workers, dieticians as well as voluntary support groups. Methods: From early 2007 onward, all patients older than 65 years with acute isolated hip fractures were included. During the whole inpatient treatment, all relevant data were captured prospectively. The data in 2006, before the implementation of the clinical pathway, were collected retrospectively through computer record system. A study of the length of stay in acute and rehabilitation hospital and also the short-term mortality rate was carried out to compare the difference before and after the implementation of the pathway. Results: From 2007 onward, more than 1300 hip fractures were treated. After the implementation of the pathway, the preoperative length of stay was markedly shortened by 4 days, from an average of 6.1 days in 2006 to 1.5 days in 2011 (P < .05). The postoperative length of stay and the overall acute hospital length of stay also improved significantly. The length of stay in rehabilitation hospital was also significantly shorter in the 4-year period. Although the number of hip fractures increased annually with increased age and number of comorbidities each year, the inpatient mortality rate showed a gradual decrease from 2.7% in 2006 to 1.25% in 2010. The 30 days mortality rate also showed a decrease from 3.65% in 2006 to 2.75% in 2010. Conclusion: Geriatric hip fracture clinical pathway is an excellent approach to the geriatric hip fracture service. The most significant improvement is the dramatic shortening of the length of hospital stay. Our success in the past 5 years has proven its value and sustainability. PMID:23936733

  5. Nursing Homes

    MedlinePlus

    ... up like a hospital. The staff provides medical care, as well as physical, speech and occupational therapy. ... relationships with residents. Some nursing homes have special care units for people with serious memory problems such ...

  6. Geriatric Small Bowel Obstruction: An Analysis of Treatment and Outcomes Compared to a Younger Cohort

    PubMed Central

    Krause, William R.; Webb, Travis P.

    2016-01-01

    Background Small bowel obstruction (SBO) is a common condition, but little is known about its presentation, management, and outcomes in geriatric patients. Methods A retrospective review was performed comparing geriatric (≥65 years of age) and non-geriatric patients admitted with SBO. Admission characteristics, treatment, and outcomes were compared. Data analysis included Student’s t test and chi-square test or Fisher exact test. Results Among 80 geriatric and 136 non-geriatric patients no difference was observed between admission characteristics, treatment, time to or type of surgery, length of post-op stay, or overall complications. Cardiac complications (15% vs 0%, p=0.0082) and sub-acute care facility discharge (29% vs 5%, p<0.001) were more common for geriatric patients. Conclusions Compared to younger adults, elderly patients with SBO have similar presentations and overall outcomes with the exception of cardiac morbidity and discharge disposition. Pre-operative attention to cardiac risk profile and discharge disposition discussion should be encouraged. Summary This study analyzes geriatric patients presenting with small bowel obstruction when cared for by an Acute Care Surgery service. Compared to younger adults, the presentation, treatment response, and outcomes are similar with the exception of cardiac complications and discharge destination. PMID:25048569

  7. Geriatric Trauma: A Radiologist's Guide to Imaging Trauma Patients Aged 65 Years and Older.

    PubMed

    Sadro, Claudia T; Sandstrom, Claire K; Verma, Nupur; Gunn, Martin L

    2015-01-01

    Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures. Clinical evaluation of geriatric trauma patients is difficult because of overall frailty, comorbid illness, and medication effects. Specific attention should be focused on the effects of medications in this population, including anticoagulants, steroids, and bisphosphonates. Radiologists should use age-appropriate algorithms for radiography, computed tomography (CT), and magnetic resonance imaging of geriatric trauma patients and follow guidelines for intravenous contrast agent administration in elderly patients with impaired renal function. Because there is less concern about risk for cancer with use of ionizing radiation in this age group, CT is the primary imaging modality used in the setting of geriatric trauma. Clinical examples are provided from the authors' experience at a trauma center where geriatric patients who have sustained major and minor injuries are treated daily. PMID:26065932

  8. Geriatric pharmacology and pharmacotherapy education for health professionals and students: a systematic review

    PubMed Central

    Keijsers, Carolina J P W; van Hensbergen, Larissa; Jacobs, Lotte; Brouwers, Jacobus R B J; de Wildt, Dick J; ten Cate, Olle Th J; Jansen, Paul A F

    2012-01-01

    AIMS Given the reported high rates of medication errors, especially in elderly patients, we hypothesized that current curricula do not devote enough time to the teaching of geriatric pharmacology. This review explores the quantity and nature of geriatric pharmacology education in undergraduate and postgraduate curricula for health professionals. METHODS Pubmed, Embase and PsycINFO databases were searched (from 1 January 2000 to 11 January 2011), using the terms ‘pharmacology’ and ‘education’ in combination. Articles describing content or evaluation of pharmacology education for health professionals were included. Education in general and geriatric pharmacology was compared. RESULTS Articles on general pharmacology education (252) and geriatric pharmacology education (39) were included. The number of publications on education in general pharmacology, but not geriatric pharmacology, has increased over the last 10 years. Articles on undergraduate and postgraduate education for 12 different health disciplines were identified. A median of 24 h (from 15 min to 4956 h) devoted to pharmacology education and 2 h (1–935 h) devoted to geriatric pharmacology were reported. Of the articles on education in geriatric pharmacology, 61.5% evaluated the teaching provided, mostly student satisfaction with the course. The strength of findings was low. Similar educational interventions were not identified, and evaluation studies were not replicated. CONCLUSIONS Recently, interest in pharmacology education has increased, possibly because of the high rate of medication errors and the recognized importance of evidence-based medical education. Nevertheless, courses on geriatric pharmacology have not been evaluated thoroughly and none can be recommended for use in training programmes. Suggestions for improvements in education in general and geriatric pharmacology are given. PMID:22416832

  9. Targeting macrophages rescues age-related immune deficiencies in C57BL/6J geriatric mice.

    PubMed

    Jackaman, Connie; Radley-Crabb, Hannah G; Soffe, Zoe; Shavlakadze, Tea; Grounds, Miranda D; Nelson, Delia J

    2013-06-01

    Changes to innate cells, such as macrophages and myeloid-derived suppressor cells (MDSCs), during aging in healthy or tumor-bearing hosts are not well understood. We compared macrophage subpopulations and MDSCs from healthy young (6-8 weeks) C57BL/6J mice to those from healthy geriatric (24-28 months) mice. Spleens, lymph nodes, and bone marrow of geriatric hosts contained significantly more M2 macrophages and MDSCs than their younger counterparts. Peritoneal macrophages from geriatric, but not young, mice co-expressed CD40 and CX3CR1 that are usually mutually exclusively expressed by M1 or M2 macrophages. Nonetheless, macrophages from geriatric mice responded to M1 or M2 stimuli similarly to macrophages from young mice, although they secreted higher levels of TGF-β in response to IL-4. We mimicked conditions that may occur within tumors by exposing macrophages from young vs. geriatric mice to mesothelioma or lung carcinoma tumor cell-derived supernatants. While both supernatants skewed macrophages toward the M2-phenotype regardless of age, only geriatric-derived macrophages produced IL-4, suggesting a more immunosuppressive tumor microenvironment will be established in the elderly. Both geriatric- and young-derived macrophages induced allogeneic T-cell proliferation, regardless of the stimuli used, including tumor supernatant. However, only macrophages from young mice induced T-cell IFN-γ production. We examined the potential of an IL-2/agonist anti-CD40 antibody immunotherapy that eradicates large tumors in young hosts to activate macrophages from geriatric mice. IL-2-/CD40-activated macrophages rescued T-cell production of IFN-γ in geriatric mice. Therefore, targeting macrophages with IL-2/anti-CD40 antibody may improve innate and T-cell immunity in aging hosts. PMID:23442123

  10. Geriatric oncology: comparing health related quality of life in head and neck cancer patients

    PubMed Central

    2011-01-01

    Background Population ageing is increasing the number of people annually diagnosed with cancer worldwide, once most types of tumours are age-dependent. High-quality healthcare in geriatric oncology requires a multimodal approach and should take into account stratified patient outcomes based on factors other than chronological age in order to develop interventions able to optimize oncology care. This study aims to evaluate the Health Related Quality of Life in head and neck cancer patients and compare the scores in geriatric and younger patients. Methods Two hundred and eighty nine head and neck cancer patients from the Oncology Portuguese Institute participated in the Health Related Quality of Life assessment. Two patient groups were considered: the geriatric (≥ 65 years old, n = 115) and the younger (45-60 years old, n= 174). The EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were used. Results Head and neck cancer patients were mostly males, 77.4% within geriatric group and 91.4% among younger patients group. The most frequent tumour locations were similar in both groups: larynx, oral cavity and oropharynx - base of the tongue. At the time of diagnosis, most of younger male patients were at disease stage III/IV (55.9%) whereas the majority of younger female patients were at disease stage I/II (83.4%). The geriatric patient distribution was found to be similar in any of the four disease stages and no gender differences were observed. We found that age (geriatrics scored generally worse), gender (females scored generally worse), and tumour site (larynx tumours denounce more significant problems between age groups) clearly influences Health Related Quality of Life perceptions. Conclusions Geriatric oncology assessments signalize age-independent indicators that might guide oncologic geriatric care optimization. Decision-making in geriatric oncology must be based on tumour characteristics and chronological age but also on performance status evaluation, co

  11. Regulatory development of geriatric medicines: To GIP or not to GIP?

    PubMed

    De Spiegeleer, Bart; Wynendaele, Evelien; Bracke, Nathalie; Veryser, Lieselotte; Taevernier, Lien; Degroote, Agnes; Stalmans, Sofie

    2016-05-01

    Geriatric patients represent the main users of medicines, but are historically often minimally included in clinical trials, resulting in a gap in the knowledge of the benefit/risk balance of medicines in this heterogeneous population. As the worldwide population is aging, the need for safe and effective medicines for older patients is proportionally increasing. The aim of this review is to provide an overview of the current regulatory status of the development of geriatric medicines, the encountered challenges and the view of the involved stakeholders, coming to the conclusion whether it is necessary or not to implement a Geriatric Investigation Plan (GIP), by analogy with pediatrics. PMID:26899877

  12. Reduction of Behavioral Psychological Symptoms of Dementia by Multimodal Comprehensive Care for Vulnerable Geriatric Patients in an Acute Care Hospital: A Case Series

    PubMed Central

    Honda, Miwako; Ito, Mio; Ishikawa, Shogo; Takebayashi, Yoichi; Tierney, Lawrence

    2016-01-01

    Management of Behavioral and Psychological Symptoms of Dementia (BPSD) is a key challenge in geriatric dementia care. A multimodal comprehensive care methodology, Humanitude, with eye contact, verbal communication, and touch as its elements, was provided to three geriatric dementia patients for whom conventional nursing care failed in an acute care hospital. Each episode was evaluated by video analysis. All patients had advanced dementia with BPSD. Failure of care was identified by patient's shouting, screaming, or abrupt movements of limbs. In this case series, conventional care failed for all three patients. Each element of care communication was much shorter than in Humanitude care, which was accepted by the patients. The average of the elements performed during the care was eye contact 0.6%, verbal communication 15.7%, and touch 0.1% in conventional care and 12.5%, 54.8%, and 44.5% in Humanitude care, respectively. The duration of aggressive behavior of each patient during care was 25.0%, 25.4%, and 66.3% in conventional care and 0%, 0%, and 0.3% in Humanitude, respectively. In our case series, conventional care was provided by less eye contact, verbal communication, and touch. The multimodal comprehensive care approach, Humanitude, decreased BPSD and showed success by patients' acceptance of care. PMID:27069478

  13. A tension between genuine care and other duties: Swedish nursing students' views of their future work.

    PubMed

    Holmström, Inger; Larsson, Jan

    2005-02-01

    There is a current need for nurses to take on new roles due to changing health care policies, economic cut-backs and shortage of staff. It is therefore important to study nursing students' view of their future profession. The theoretical framework was contemporary theories of competence development, which has shown that people's understanding of their work is expressed in their actions. The aim of this study was to describe nursing students' understanding of their future professional role in health care. A purposeful sample of 12 nursing students wrote narratives. The texts were condensed in five steps using the Empirical Phenomenological Psychological Method. The essence of the students' view of their future work was A tension between genuine nursing care and other duties. Four themes constituted this essence: professional status, working conditions and stress, evidence-based nursing contra holistic care, teamwork, co-operation and disrespect, and intensive care instead of geriatrics. This study highlights pedagogic and practical problems that need to be constructively addressed. The nursing students' eagerness to care in a holistic way needs to be acknowledged and used in a fruitful way. This core function of nursing needs to be integrated with up-to-date nursing research. PMID:15701541

  14. Music Therapy Training for Undergraduate Nursing Students: A Modality to Foster Interest in Gerontological Nursing.

    PubMed

    Lin, Hui-Chuan; Chen, Shu-Ling; Hsieh, Chia-En; Lin, Ping-Yi

    2016-06-01

    gerontological nursing. 2. Describe the results of using music therapy to create positive attitudes toward older adults. DISCLOSURE STATEMENT Neither the planners nor the authors have any conflicts of interest to disclose. Nursing students generally have a negative attitude toward older adults. Preparing nurses to meet the care needs of an expanding aging population is a challenge for nursing educators. The purpose of the current study was to explore whether incorporating music therapy into a practical geriatric nursing course at a nursing home cultivates positive attitudes toward older adults, raises students' willingness to work with older adults, and increases their interest in specializing in gerontological nursing after graduation. Focus groups were conducted to collect data from three participant groups (N = 20). Verbatim transcripts of audiorecorded interviews were analyzed using content analysis, which revealed four themes: (a) better appreciation and understanding of music therapy, (b) role modeling instructors' successful experience and positive attitude toward older adults, (c) changing attitudes toward older adults, and (d) improving interaction skills with older adults. Results suggested music can be integrated into a gerontological nursing course to enhance students' motivation to learn, empathize, and approach older adults. [Journal of Gerontological Nursing, 42(6), 25-31.]. PMID:27064607

  15. A user's guide to enhancing geriatrics in an undergraduate medical school curriculum: the ten-step model to winning the "geriatric game".

    PubMed

    Medina-Walpole, Annette; Clark, Nancy S; Heppard, Brian; Dannefer, Elaine; Hall, William; McCann, Robert

    2004-05-01

    In 1999, the University of Rochester School of Medicine and Dentistry committed to major restructuring of its undergraduate medical school curriculum. A distinguishing feature of this reform was the planned emphasis on and integration of several core topics or themes throughout the 4 years of the curriculum. One of these curricular themes was aging. The faculty in geriatrics was presented with an unparalleled opportunity to develop a geriatrics curriculum of major proportions through the development of an aging theme. Through a user's guide approach based on the authors' experience to date, this article identifies the 10 steps necessary to "win the geriatric game" successfully integrating an aging theme into an undergraduate medical school curriculum. Since the initiation of the aging theme, several new courses, cases, and conferences have been added or enhanced, affecting all 4 years of the curriculum. Key operational challenges included successful engagement of course directors, tracking the actual experience of the aging theme, and evaluation of students' attainment of learning objectives and eventual career choices. The authors' experience suggests that an aging theme can successfully enhance the geriatrics curricular content of undergraduate education and strongly affect students across all 4 years. This 10-step approach may serve as a model for other universities committed to integrating geriatrics across the full undergraduate medical curriculum. PMID:15086668

  16. Actualizing a mobile integrated system for geriatric care.

    PubMed

    Chew, Han Ei; Faber, Johannes; Liu, Zhiming; Madera, Vanessa; Qamar, Nafees

    2013-01-01

    Population aging looms over countries all over the world. The social and economic implications of this phenomenon extend beyond the individual person and the immediate family, affecting broader society and the global community in profound ways. Aging populations increase pressure on already over-burdened public health care services and expenditures. To address this impending predicament, many health care providers and countries have turned to technological solutions. The near-ubiquity of mobile devices entails that mHealth will rapidly become a key component of technologically-enabled health care delivery services. This poster presents research and engineering challenges for a sustainable ICT solution that supports information exchange for mobile geriatric care. PMID:23920883

  17. [Geriatric particularities of Parkinson's disease: Clinical and therapeutic aspects].

    PubMed

    Belin, J; Houéto, J L; Constans, T; Hommet, C; de Toffol, B; Mondon, K

    2015-12-01

    Parkinson's disease (PD) is a frequent and complex progressive neurological disorder that increases in incidence with age. Although historically PD has been characterized by the presence of progressive dopaminergic neuronal loss of the substantia nigra, the disease process also involves neurotransmitters other that dopamine and regions of the nervous system outside the basal ganglia. Its clinical presentation in elderly subjects differs from that in younger subjects, with more rapid progression, less frequent tremor, more pronounced axial signs, more frequent non-motor signs linked to concomitant degeneration of non-dopaminergic systems, and more frequent associated lesions. Despite the high prevalence of PD in elderly subjects, few therapeutic trials have been conducted in geriatric patients. Nevertheless, to improve functional disability while ensuring drug tolerance, the principles of optimized and multidisciplinary clinical management have to be known. The aim of this review is to provide an update on clinical and therapeutic features of PD specifically observed in elderly subjects. PMID:26573332

  18. Pelvic radiation therapy for gynecologic malignancy in geriatric patients

    SciTech Connect

    Grant, P.T.; Jeffrey, J.F.; Fraser, R.C.; Tompkins, M.G.; Filbee, J.F.; Wong, O.S.

    1989-05-01

    Thirty-one patients, aged 75 years or older, who received pelvic radiation therapy as part of primary treatment for a gynecologic malignancy, were reviewed. Ten patients (32%) failed to complete their treatment and 4 patients (13%) died of treatment-related complications. The treatment-related complications were independent of increasing age, but did correlate closely with the patients' pretreatment ECOG performance status. Ten patients with performance levels of 2 or higher had a mortality rate of 30%, while 70% failed to complete treatment. Treatment fractions of greater than 220 cGy per day also resulted in unacceptably high complication rates. Alternative treatment formats should be considered in geriatric patients with poor initial performance levels.

  19. The prevalence of drivers in acute geriatric wards.

    PubMed Central

    Morgan, R.; Turnbull, C. J.; King, D.

    1995-01-01

    An audit of 150 patients on five acute geriatric wards found that 28 (19%) still drove. Forty-three (28%) used to drive but had given up, whilst 79 (53%) (76 of whom were female) had never driven. Former drivers gave the main reason for stopping as cost. No driver could recall being advised about driving by a doctor. Twenty-two drivers (79%) had a significant clinical condition that could affect driving, ranging from blackouts to arthritis. It is recommended that all elderly patients should be asked if they drive and any clinical conditions they might have that would adversely affect their driving be sought. Appropriate advice should be given by doctors to their elderly patients in order to safeguard them and the public from road traffic accidents. PMID:8545286

  20. Recent Advances in Neuroimaging Biomarkers in Geriatric Psychiatry

    PubMed Central

    Khandai, Abhisek C.; Aizenstein, Howard J.

    2013-01-01

    Neuroimaging, both structural and functional, serve as useful adjuncts to clinical assessment, and can provide objective, reliable means of assessing disease presence and process in the aging population. In the following review we briefly explain current imaging methodologies. Then, we analyze recent developments in developing neuroimaging biomarkers for two highly prevalent disorders in the elderly population- Alzheimer's disease (AD) and late-life depression (LLD). In AD, efforts are focused on early diagnosis through in vivo visualization of disease pathophysiology. In LLD, recent imaging evidence supports the role of white matter ischemic changes in the pathogenesis of depression in the elderly, the “vascular hypothesis.” Finally, we discuss potential roles for neuroimaging biomarkers in geriatric psychiatry in the future. PMID:23636984

  1. Xerostomia in the Geriatric Patient: Causes, Oral Manifestations, and Treatment.

    PubMed

    Ouanounou, Aviv

    2016-05-01

    Xerostomia, or dry mouth, is common among elderly people and is typically associated with decreased salivary gland function. Causes of xerostomia in the geriatric population have been attributed to the use of medications, chronic disorders, and radiation therapy to the head and neck region. Patients with chronic xerostomia may have multiple oral and dental consequences such as dental caries, periodontal disease, fungal infections, ill-fitting dentures, and taste alterations. Xerostomia can seriously impact quality of life and may alter speech, eating, and swallowing. Current therapeutics for the management of xerostomia are grouped as local and systemic salivary stimulation. This article reviews the main reasons for xerostomia and the complications it causes in the oral cavity. It also discusses the pharmacologic and nonpharmacologic agents used to treat this condition. PMID:27213776

  2. Nursing Leadership.

    PubMed

    Crisp, Carol

    2016-01-01

    Nurse transformational leaders can serve in academic settings and at local, national, international professional nursing organizations and community-based groups. As a transformational leader, nurses can lead in any workplace. According to a study by Stanley (2012), clinical leaders are not sought for their capacity to outline a vision, but for their values and beliefs on display that are easily recognized in their actions. This encompasses the moral component of transformational leadership. It is the APRNs duty to continue to strive towards a better vision for the well-being of all nurses, patients, and colleagues. Autonomous APRNs are happier, healthier, and better prepared to provide the best patient care to their patients. We should not be happy to sit back and let others fight this fight. APRNs need to be on the frontline, leading the way. This is only an insight that I have gained after many frustrating years of cheering our profession and then being made to feel inferior at the same time. Only nurses, who have that nurturing spirit, would hold back if they felt it might hurt others. Don't back off or hold back! It might hurt those that follow! PMID:27089563

  3. The growth of gerontology & geriatrics in the United States.

    PubMed

    Schneider, E L

    1992-05-01

    Since the confirmation of the Older American's Act (OAA) in 1965, the growth of gerontology and geriatrics, has literally come of age in the United States. Although individual aging courses were offered in higher education prior to passage of the OAA, few gerontology programs had been established. On campuses where gerontology courses were available, they represented electives connected with a pre-existing discipline, such as social work or family studies. However, 1965 was a watershed year for gerontology instruction since it heralded the provision of federal funding support, beginning with that of the Administration on Aging (AoA), to help develop, pilot, and oversee gerontological programs in American institutions of higher learning. Initially, instruction was at an undergraduate level, but later gerontology degree programs were established at the master's level, with the first gerontology degree program originating at North Texas State University, in 1967. This program was followed a year later (1968) by a program at the University of South Florida. While funding from AoA began in 1966, funding from other federal agencies (e.g., the Bureau of Health Professions (BHP); the National Institute on Aging (NIA); the National Institute of Mental Health (NIMH), Mental Disorders of Aging Branch; and the Veteran's Administration (VA))--the five agencies that became the basis for a 1984 and 1987 Report on Education and Training in Geriatrics and Gerontology,--did not begin until the mid 1970s. The mid 1970s reflected the growing awareness of the demographic shift in America and around the world, particularly in developed nations.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1507509

  4. Ageing Renal Patients: We Need More Collaboration between Geriatric Services and Nephrology Departments

    PubMed Central

    Alston, Helen; Burns, Aine

    2015-01-01

    There has been a significant increase in the number of frail older patients diagnosed with advanced chronic kidney disease (CKD) over the past thirty years. These elderly patients have high levels of comorbidity, and as a consequence the face of renal medicine is changing—There is an increasing need to focus on traditionally geriatric areas of expertise such as falls prevention and rehabilitation, and to shift our emphasis onto improving patient well-being rather than longevity. Over the past decade, many nephrologists have found that they are already acting as de facto “amateur geriatricians”. This denies patients both the benefits of specialist geriatric assessment, and equally importantly denies them access to the wider geriatric multidisciplinary team. This article describes the prevalence and underlying causes of the so-called “Geriatric Giants” in patients with advanced CKD, and discusses possible improvements in care that closer working with geriatricians could bring.

  5. Geriatric dermatoses: a clinical review of skin diseases in an aging population.

    PubMed

    Jafferany, Mohammad; Huynh, Trung V; Silverman, Melissa A; Zaidi, Zohra

    2012-05-01

    Geriatric dermatoses are a challenging job for the physician in terms of diagnosis, management, and followup. Since skin of the elderly population is going through a lot of changes from both an intrinsic and extrinsic point of view, it is imperative for the physician to have a better understanding of the pathophysiology of geriatric skin disorders and their specific management, which differs slightly from an adult population. This review focuses on a brief introduction to the pathophysiological aspects of skin disorders in elderly, the description of some common geriatric skin disorders and their management and the new emerging role of psychodermatological aspects of geriatric dermatoses is also discussed. At the end, ten multiple choice questions are also added to further enhance the knowledge base of the readers. PMID:22515576

  6. Activating the knowledge-to-action cycle for geriatric care in India

    PubMed Central

    2011-01-01

    Despite a rapidly aging population, geriatrics - the branch of medicine that focuses on healthcare of the elderly - is relatively new in India, with many practicing physicians having little knowledge of the clinical and functional implications of aging. Negative attitudes and limited awareness, knowledge or acceptance of geriatrics as a legitimate discipline contribute to inaccessible and poor quality care for India's old. The aim of this paper is to argue that knowledge translation is a potentially effective tool for engaging Indian healthcare providers in the delivery of high quality geriatric care. The paper describes India's context, including demographics, challenges and current policies, summarizes evidence on provider behaviour change, and integrates the two in order to propose an action plan for promoting improvements in geriatric care. PMID:22136552

  7. Preparing Social Work Students for Interprofessional Practice in Geriatric Health Care: Insights from Two Approaches

    ERIC Educational Resources Information Center

    Bonifas, Robin P.; Gray, Amanda K.

    2013-01-01

    Although several interprofessional education projects have addressed training allied health students for effective teamwork in geriatrics, few curriculum evaluation studies have examined differences in learning outcomes between interprofessional and traditional uniprofessional approaches, especially for social work students. This paper compares…

  8. 78 FR 6406 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-01-30

    ... Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that a meeting of the... dementia and program advances in palliative care, and performance and oversight of VA Geriatric...

  9. 78 FR 12831 - Geriatrics and Gerontology Advisory Committee, Notice of Meeting Amendment

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-02-25

    ... Veterans Affairs (VA) gives notice under the Federal Advisory Committee Act, 5 U.S.C. App. 2, that a... planning activities in geriatrics and extended care, recent VHA efforts regarding dementia and...

  10. A Novel Geriatric Screening Tool in Older Patients with Cancer: The Korean Cancer Study Group Geriatric Score (KG)-7

    PubMed Central

    Kim, Jin Won; Kim, Se-Hyun; Kim, Yu Jung; Lee, Keun-Wook; Kim, Kwang-Il; Lee, Jong Seok; Kim, Cheol-Ho; Kim, Jee Hyun

    2015-01-01

    Geriatric assessment (GA) is resource-consuming, necessitating screening tools to select appropriate patients who need full GA. The objective of this study is to design a novel geriatric screening tool with easy-to-answer questions and high performance objectively selected from a large dataset to represent each domain of GA. A development cohort was constructed from 1284 patients who received GA from May 2004 to April 2007. Items representing each domain of functional status, cognitive function, nutritional status, and psychological status in GA were selected according to sensitivity (SE) and specificity (SP). Of the selected items, the final questions were chosen by a panel of oncologists and geriatricians to encompass most domains evenly and also by feasibility and use with cancer patients. The selected screening questions were validated in a separate cohort of 98 cancer patients. The novel screening tool, the Korean Cancer Study Group Geriatric Score (KG)-7, consisted of 7 items representing each domain of GA. KG-7 had a maximal area under the curve (AUC) of 0.93 (95% confidence interval (CI) 0.92−0.95) in the prediction of abnormal GA, which was higher than that of G-8 (0.87, 95% CI 0.85–0.89) within the development cohort. The cut-off value was decided at ≤ 5 points, with a SE of 95.0%, SP of 59.2%, positive predictive value (PPV) of 85.3%, and negative predictive value (NPV) of 82.6%. In the validation cohort, the AUC was 0.82 (95% CI 0.73−0.90), and the SE, SP, PPV, and NPV were 89.5%, 48.6%, 77.3%, and 75.0%, respectively. Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts. In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA. The KG-7 also predicted OS. Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention. PMID:26401951

  11. A Novel Geriatric Screening Tool in Older Patients with Cancer: The Korean Cancer Study Group Geriatric Score (KG)-7.

    PubMed

    Kim, Jin Won; Kim, Se-Hyun; Kim, Yu Jung; Lee, Keun-Wook; Kim, Kwang-Il; Lee, Jong Seok; Kim, Cheol-Ho; Kim, Jee Hyun

    2015-01-01

    Geriatric assessment (GA) is resource-consuming, necessitating screening tools to select appropriate patients who need full GA. The objective of this study is to design a novel geriatric screening tool with easy-to-answer questions and high performance objectively selected from a large dataset to represent each domain of GA. A development cohort was constructed from 1284 patients who received GA from May 2004 to April 2007. Items representing each domain of functional status, cognitive function, nutritional status, and psychological status in GA were selected according to sensitivity (SE) and specificity (SP). Of the selected items, the final questions were chosen by a panel of oncologists and geriatricians to encompass most domains evenly and also by feasibility and use with cancer patients. The selected screening questions were validated in a separate cohort of 98 cancer patients. The novel screening tool, the Korean Cancer Study Group Geriatric Score (KG)-7, consisted of 7 items representing each domain of GA. KG-7 had a maximal area under the curve (AUC) of 0.93 (95% confidence interval (CI) 0.92-0.95) in the prediction of abnormal GA, which was higher than that of G-8 (0.87, 95% CI 0.85-0.89) within the development cohort. The cut-off value was decided at ≤ 5 points, with a SE of 95.0%, SP of 59.2%, positive predictive value (PPV) of 85.3%, and negative predictive value (NPV) of 82.6%. In the validation cohort, the AUC was 0.82 (95% CI 0.73-0.90), and the SE, SP, PPV, and NPV were 89.5%, 48.6%, 77.3%, and 75.0%, respectively. Furthermore, patients with higher KG-7 scores showed significantly longer overall survival (OS) in the development and validation cohorts. In conclusions, the KG-7 showed high SE and NPV to predict abnormal GA. The KG-7 also predicted OS. Given the results of our studies, the KG-7 could be used effectively in countries with high patient burden and low resources to select patients in need of full GA and intervention. PMID:26401951

  12. Geriatric Medicine Leadership of Health Care Transformation: To Be or Not To Be?

    PubMed Central

    Heckman, George A.; Molnar, Frank J.; Lee, Linda

    2013-01-01

    Geriatric Medicine is well-suited to inform and lead health-care system redesign to address the needs of seniors with complex conditions. We posit that geriatricians must urgently consider how to “brand” Geriatric Medicine in a manner that garners active support from those outside the specialty, including how to adapt practice patterns to better meet the needs of patients and of the health-care system. PMID:24278096

  13. The dilemma of implantable cardioverter-defibrillator therapy in the geriatric population

    PubMed Central

    Revenco, Diana; Morgan, James P; Tsao, Lana

    2011-01-01

    Current guidelines for implantable cardioverter-defibrillator (ICD) therapy in heart failure patients were established by multiple device trials; however, very few geriatric patients (patients ≥ 65 years old) were included in these studies. This article explores the controversies of ICD implantation in the geriatric population, management of delivered ICD therapy in this age group, and the end of life care in patients with ICD. PMID:22783305

  14. Geriatric consultation can aid in complex treatment decisions for elderly cancer patients.

    PubMed

    Schiphorst, A H W; Ten Bokkel Huinink, D; Breumelhof, R; Burgmans, J P J; Pronk, A; Hamaker, M E

    2016-05-01

    Treatment decisions for elderly cancer patients can be challenging. A geriatric assessment may identify unknown medical conditions, give insight on patients' ability to tolerate treatment and guide treatment decisions. Our aim was to study the value of a geriatric consultation in oncological decision-making. Data on cancer patients referred for geriatric consultation for clinical optimisation or due to uncertainty regarding their optimal treatment strategy were prospectively analysed. Outcome of geriatric evaluations, non-oncological interventions and suggested adaptations of oncological treatment proposals were evaluated. Seventy-two patients were referred for consultation, over half of which in a curative treatment setting. Prevalence of geriatric syndromes was 93%, previously undiagnosed conditions were identified in 49% of patients and non-oncological interventions were initiated in 56%. Time was spent discussing patients' priorities (53% of consultations), expectations on treatment (50%) and advance care planning (14%). For 82% of patients, suggestions were made regarding the optimal treatment decision: a more intensive treatment was recommended in 39%, a less intensive therapy for 42% and in 19% only supportive care was suggested. The results demonstrate that a geriatric consultation can aid in complex treatment decisions and may allow for a reduction in over- and undertreatment of elderly cancer patients. PMID:26211484

  15. Engineering the fitness of older patients for chemotherapy: an exploration of Comprehensive Geriatric Assessment in practice.

    PubMed

    McCarthy, Alexandra L; Cook, Peta S; Yates, Patsy

    2014-03-01

    Clinicians often report that currently available methods to assess older patients, including standard clinical consultations, do not elicit the information necessary to make an appropriate cancer treatment recommendation for older cancer patients. An increasingly popular way of assessing the potential of older patients to cope with chemotherapy is a Comprehensive Geriatric Assessment. What constitutes Comprehensive Geriatric Assessment, however, is open to interpretation and varies from one setting to another. Furthermore, Comprehensive Geriatric Assessment's usefulness as a predictor of fitness for chemotherapy and as a determinant of actual treatment is not well understood. In this article, we analyse how Comprehensive Geriatric Assessment was developed for use in a large cancer service in an Australian capital city. Drawing upon Actor-Network Theory, our findings reveal how, during its development, Comprehensive Geriatric Assessment was made both a tool and a science. Furthermore, we briefly explore the tensions that we experienced as scholars who analyse medico-scientific practices and as practitioner-designers charged with improving the very tools we critique. Our study contributes towards geriatric oncology by scrutinising the medicalisation of ageing, unravelling the practices of standardisation and illuminating the multiplicity of 'fitness for chemotherapy'. PMID:23703221

  16. Managed care organizations' arrangements with nurse practitioners: a Connecticut perspective.

    PubMed

    O'Donnell, J P; Cohen, S S; Mason, D J; Baxter, K; Chase, A B

    1998-01-01

    Executives in more than 50% of managed care organizations (MCOs) in New York and Connecticut were interviewed for information on the roles, participation, and listing of NPs as primary care providers. MCO executives are highly satisfied with their primary care provider NPs, particularly in women's health and geriatrics, secondary to spending more time teaching and explaining procedures than physicians. Among both health care professionals and the general public there is an overall lack of current knowledge and/or confusion about NPs and their practice. Eighty-two percent of executives in MCOs thought their organization should encourage the use of NPs as primary care providers. Beginning in the early 1960s, advanced practice nursing has shown steady growth. Research has found that NPs provide cost-effective, quality-driven patient care (Brown & Grimes, 1995; Cohen & Juszczak, 1997; Frampton & Wall, 1994; Hardy & Evans, 1995). Many thought health care reform would lead to an expansion of advanced practice nurses (APNs) and other nonphysician providers as primary care providers (Aiken & Salmon, 1994). Funding for and enrollment in graduate nursing programs rose nationwide (American Association of Colleges of Nursing, 1996). Anecdotal reports indicated that NPs were not included in MCO primary care provider panels. The purpose of this study was to explore MCO arrangements with nurse practitioners and the factors that influence them. PMID:10614235

  17. Socializing nurses for nursing entrepreneurship roles.

    PubMed

    Batra, C

    1990-01-01

    Whatever directions nursing takes in the future, it is likely that creative and motivated nurses, more and more, will seek to run their own businesses. Batra prepares the student nurse for this eventuality by devising a course that teaches the student how to organize an entrepreneurial nursing business. PMID:2300274

  18. Clinical research nurse or nurse researcher?

    PubMed

    Jones, Helen Claire

    This article gives an overview of two research-related roles that can form part of a nurse's career path: clinical research nurse and nurse researcher. It highlights the influences on both roles, and the skills and differences within them, as well as offering advice on how nurses can access either role. PMID:26182597

  19. Identifying and evaluating electronic learning resources for use in adult-gerontology nurse practitioner education.

    PubMed

    Thompson, Hilaire J; Belza, Basia; Baker, Margaret; Christianson, Phyllis; Doorenbos, Ardith; Nguyen, Huong

    2014-01-01

    Enhancing existing curricula to meet newly published adult-gerontology advanced practice registered nurse (APRN) competencies in an efficient manner presents a challenge to nurse educators. Incorporating shared, published electronic learning resources (ELRs) in existing or new courses may be appropriate in order to assist students in achieving competencies. The purposes of this project were to (a) identify relevant available ELR for use in enhancing geriatric APRN education and (b) to evaluate the educational utility of identified ELRs based on established criteria. A multilevel search strategy was used. Two independent team members reviewed identified ELR against established criteria to ensure utility. Only resources meeting all criteria were retained. Resources were found for each of the competency areas and included formats such as podcasts, Web casts, case studies, and teaching videos. In many cases, resources were identified using supplemental strategies and not through traditional search or search of existing geriatric repositories. Resources identified have been useful to advanced practice educators in improving lecture and seminar content in a particular topic area and providing students and preceptors with additional self-learning resources. Addressing sustainability within geriatric APRN education is critical for sharing of best practices among educators and for sustainability of teaching and related resources. PMID:24720944

  20. Nursing Matters.

    ERIC Educational Resources Information Center

    Adamson, Charles

    A two-semester English-for-Special-Purposes (ESP) course designed for nursing students at a Japanese university is described, including the origins and development of the course, text development, and teaching methods. The content-based course was designed to meet licensure requirements for English language training, emphasized listening and…

  1. A Long-Term Care—Comprehensive Geriatric Assessment (LTC-CGA) Tool: Improving Care for Frail Older Adults?

    PubMed Central

    Marshall, Emily G.; Clarke, Barry S.; Varatharasan, Nirupa; Andrew, Melissa K.

    2015-01-01

    Background Most older adults living in long-term care facilities (LTCF) are frail and have complex care needs. Holistic understanding of residents’ health status is key to providing good care. Comprehensive Geriatric Assessment (CGA) is a valid assessment method which aims to embrace complexity. Here we aimed to study a CGA that has been modified for use in long-term care (the LTC-CGA) and to investigate its acceptability and usefulness to stakeholders and users. Methods This mixed methods study, conducted in 10 LTCFs in Halifax, Nova Scotia, reviewed 598 resident charts from pre- and post-implementation of the LTC-CGA. Qualitative methods explored stakeholder perspectives (physicians, nurses, paramedics, administrators, residents and families) though focus groups. Results The LTC-CGA was present in 78% of LTCF charts in the post -implementation, period though it did not appear in acute care charts of transferred residents, despite the intention that it accompany residents between care sites. Some items had suboptimal completion rates (e.g., Advance Directives at 56.4%), though these were located in other sections of the LTCF chart (98.2%). Nevertheless, qualitative findings suggest the LTC-CGA describes a clinical baseline health status which enabled timely and informed clinical decision-making. Conclusions The LTC-CGA is a useful resource whose full capacity may not yet have been realized. PMID:25825606

  2. Effect of automated drug distribution systems on medication error rates in a short-stay geriatric unit

    PubMed Central

    Cousein, Etienne; Mareville, Julie; Lerooy, Alexandre; Caillau, Antoine; Labreuche, Julien; Dambre, Delphine; Odou, Pascal; Bonte, Jean-Paul; Puisieux, François; Decaudin, Bertrand; Coupé, Patrick

    2014-01-01

    Rationale, aims and objectives To assess the impact of an automated drug distribution system on medication errors (MEs). Methods Before-after observational study in a 40-bed short stay geriatric unit within a 1800 bed general hospital in Valenciennes, France. Researchers attended nurse medication administration rounds and compared administered to prescribed drugs, before and after the drug distribution system changed from a ward stock system (WSS) to a unit dose dispensing system (UDDS), integrating a unit dose dispensing robot and automated medication dispensing cabinet (AMDC). Results A total of 615 opportunities of errors (OEs) were observed among 148 patients treated during the WSS period, and 783 OEs were observed among 166 patients treated during the UDDS period. ME [medication administration error (MAE)] rates were calculated and compared between the two periods. Secondary measures included type of errors, seriousness of errors and risk reduction for the patients. The implementation of an automated drug dispensing system resulted in a 53% reduction in MAEs. All error types were reduced in the UDDS period compared with the WSS period (P < 0.001). Wrong dose and wrong drug errors were reduced by 79.1% (2.4% versus 0.5%, P = 0.005) and 93.7% (1.9% versus 0.01%, P = 0.009), respectively. Conclusion An automated UDDS combining a unit dose dispensing robot and AMDCs could reduce discrepancies between ordered and administered drugs, thus improving medication safety among the elderly. PMID:24917185

  3. What Is Nursing Informatics?

    ERIC Educational Resources Information Center

    McGonigle, D.; And Others

    Information technology has developed to the point of providing a means to manage nursing and related health-care data effectively for nursing administrators, educators, practitioners, and researchers. Therefore, the newly recognized area of nursing informatics is important to the nursing profession as a whole. Nursing informatics is defined as the…

  4. Camp Nursing: Student Internships.

    ERIC Educational Resources Information Center

    Harwood, Catherine Hoe; Van Hofwegen, Lynn

    2002-01-01

    Camps can meet or supplement their health care delivery needs by using student nurses. Three models for student nurse internships, basic information about nursing education, and tips for negotiating student nurse internships are described. Sidebars present resources for camp health centers, nursing student competence characteristics, types of…

  5. Leaders from Nursing's History.

    ERIC Educational Resources Information Center

    Fondiller, Shirley H.; And Others

    1995-01-01

    Looks at the lives and accomplishments of four leaders in professional nursing: (1) Loretta Ford, who championed the cause of nurse practitioners; (2) Mable Staupers, a pioneer in community health and nursing; (3) Janet Geister, a leader in private nursing; and (4) Isabel Stewart, who led the movement to standardize nursing education. (JOW)

  6. Clashes At Nursing Homes Not Uncommon

    MedlinePlus

    ... behavior, the study found. Dr. Lisa Gibbs, a geriatrics specialist who was not involved in the study, ... medical conditions," said Gibbs, who is chief of geriatrics and gerontology at the University of California, Irvine. " ...

  7. Validation of screening tools to assess appetite among geriatric patients.

    PubMed

    Hanisah, R; Suzana, S; Lee, F S

    2012-07-01

    Poor appetite is one of the main contributing factors of poor nutritional status among elderly individuals. Recognizing the importance of assessment of appetite, a cross sectional study was conducted to determine the validity of appetite screening tools namely, the Council on Nutrition Appetite questionnaire (CNAQ) and the simplified nutritional appetite questionnaire (SNAQ) against the appetite, hunger and sensory perception questionnaire (AHSPQ), measures of nutritional status and food intake among geriatric patients at the main general hospital in Malaysia. Nutritional status was assessed using the subjective global assessment (SGA) while food intake was measured using the dietary history questionnaire (DHQ). Anthropometric parameters included weight, height, body mass index (BMI), calf circumference (CC) and mid upper arm circumference (MUAC). A total of 145 subjects aged 60 to 86 years (68.3 ± 5.8 years) with 31.7% men and 68.3% women were recruited from outpatients (35 subjects) and inpatients (110 subjects) of Kuala Lumpur Hospital of Malaysia. As assessed by SGA, most subjects were classified as mild to moderately malnourished (50.4%), followed by normal (38.6%) and severely malnourished (11.0%). A total of 79.3% and 57.2% subjects were classified as having poor appetite according to CNAQ and SNAQ, respectively. CNAQ (80.9%) had a higher sensitivity than SNAQ (69.7%) when validated against nutritional status as assessed using SGA. However, the specificity of SNAQ (62.5%) was higher than CNAQ (23.2%). Positive predictive value for CNAQ and SNAQ were 62.6% and 74.7%, respectively. Cronbach's alpha for CNAQ and SNAQ were 0.546 and 0.578, respectively. History of weight loss over the past one year (Adjusted odds ratio 2.49) (p < 0.01) and thiamine intake less than the recommended nutrient intake (RNI) (Adjusted odds ratio 3.04) (p < 0.05) were risk factors for poor appetite among subjects. In conclusion, malnutrition and poor appetite were prevalent among the

  8. Developing Leadership in Geriatric Education. Proceedings of the Annual Summer Geriatric Institute (5th, Lexington, Kentucky, July 23-25, 1990).

    ERIC Educational Resources Information Center

    Gardner, Davis L., Ed.; Patzwald, Gari-Anne, Ed.

    Papers in these proceedings are organized into four sections: (1) Research Studies in Aging; (2) Innovative Approaches in Geriatric Education; (3) Faculty Development Models; and (4) "The Publication Process: Perils and Pearls" (Workshop). Clinical Experiences: Design Not Chance" (Matzo); "The Development of a Collaborative Gerontological Research…

  9. Developments of geriatric autopsy database and Internet-based database of Japanese single nucleotide polymorphisms for geriatric research (JG-SNP).

    PubMed

    Sawabe, Motoji; Arai, Tomio; Kasahara, Ichiro; Esaki, Yukiyoshi; Nakahara, Ken-ichi; Hosoi, Takayuki; Orimo, Hajime; Takubo, Kaiyo; Murayama, Shigeo; Tanaka, Noriko

    2004-08-01

    To facilitate geriatric research on the roles of genetic polymorphisms of candidate genes, two databases were developed based on data obtained from autopsy examinations of elderly subjects: the geriatric autopsy database (GEAD) and the Japanese single nucleotide polymorphisms (SNP) database for geriatric research (JG-SNP) which is accessible on the Internet (http://www.tmgh.metro.tokyo.jp/jg-snp/english/E_top.html). The data for the GEAD were derived from 1074 consecutive autopsy cases (565 male and 509 female cases) with an average age of 80 years. The GEAD was installed on a stand-alone Windows 2000 server using Oracle 8i as the database application. The GEAD contains clinical diagnoses of 26 geriatric diseases, histories of smoking and alcohol consumption, pathological findings (720 items), severity of atherosclerosis, genetic polymorphism data, etc. On the JG-SNP website, case distribution corresponding to a specified SNP or disease can be searched or downloaded. Although there are several Internet-based SNP databases such as dbSNP, no databases are available at present on the web that contain both SNP data and phenotypic data. As autopsy studies can provide large amounts of accurate medical information, including the presence of undiagnosed diseases such as latent cancers, the GEAD is a unique and excellent database for research on genetic polymorphisms. PMID:15336912

  10. Child Psychiatric Nursing Option.

    ERIC Educational Resources Information Center

    Koehler, Mary Frances

    1981-01-01

    Describes a course at the Indiana University School of Nursing which allows senior students in a baccalaureate nursing program to concentrate on emotionally disturbed children in an advanced nursing course. Discusses course philosophy, clinical experiences, and program results. (CT)

  11. International Transplant Nurses Society

    MedlinePlus

    ... Register for the 25th Annual ITNS Symposium The International Transplant Nurses Society (ITNS) cordially invites transplant nurses ... Barriers (PDF) This pocket guide, developed by the International Transplant Nurses Society (ITNS), provides an overview of ...

  12. Geriatric, Ethics, and Palliative Care: Tending to the Mind & Spirit

    ERIC Educational Resources Information Center

    Richeson, Nancy E.; White, Paula; Nadeau, Kathy K.; Chessa, Frank; Dreher, George K.; Frost, Cindy; Hurwitz, Craig; Nesbitt, Marylou; Scotton, David W.; Todorich, Patricia

    2008-01-01

    The purpose of this paper was to examine the outcomes from the William Randolph Hearst Scholars Program (HSP) conducted at Maine Medical Center, Portland, Maine from September 2005 to September 2006. The HSP was an interdisciplinary (nursing, rehabilitation therapies, social work, clergy, pharmacy, physicians, respiratory therapy, physician's…

  13. Developing nursing care plans.

    PubMed

    Ballantyne, Helen

    2016-02-24

    This article aims to enhance nurses' understanding of nursing care plans, reflecting on the past, present and future use of care planning. This involves consideration of the central theories of nursing and discussion of nursing models and the nursing process. An explanation is provided of how theories of nursing may be applied to care planning, in combination with clinical assessment tools, to ensure that care plans are context specific and patient centred. PMID:26907149

  14. Geriatric education centers address medication issues affecting older adults.

    PubMed Central

    Kahl, A; Blandford, D H; Krueger, K; Zwick, D I

    1992-01-01

    Serious problems have been identified in the prescribing of medications for elderly patients and use of prescription and nonprescription drugs by older persons. Overuse, underuse, and inappropriate use of drugs by the elderly have been widely documented, and the harmful consequences have been described. This paper reviews information concerning the need for action to improve health professionals' knowledge and skills with respect to drugs and the elderly and activities being undertaken by geriatric education centers (GECs) to enhance these capacities. Grant support for the centers from the Health Resources and Services Administration, a Public Health Service component agency, began in 1983. In fiscal year 1992 there are 31 centers operating in 26 States. The centers are multi-institutional and conduct four types of educational activities. These include review of pharmacological issues for multidisciplinary groups, specialized training for pharmacists, discipline-specific programs focusing on medication issues, and activities aimed at educating the public. Examples of the GECs' educational activities are given. PMID:1738807

  15. A current perspective on geriatric lower urinary tract dysfunction

    PubMed Central

    Jung, Ha Bum; Kim, Hyung Jee

    2015-01-01

    Lower urinary tract dysfunction-such as urinary incontinence (UI), detrusor overactivity, and benign prostatic hyperplasia-is prevalent in elderly persons. These conditions can interfere with daily life and normal functioning and lead to negative effects on health-related quality of life. UI is one of the most common urologic conditions but is poorly understood elderly persons. The overall prevalence of UI increases with age in both men and women. Elderly persons often neglect UI or dismiss it as part of the normal aging process. However, UI can have significant negative effects on self-esteem and has been associated with increased rates of depression. UI also affects quality of life and activities of daily living. Although UI is more common in elderly than in younger persons, it should not be considered a normal part of aging. UI is abnormal at any age. The goal of this review is to provide an overview of the cause, classification, evaluation, and management of geriatric lower urinary tract dysfunction. PMID:25874039

  16. [Cases of prosthodontic tissue reconditioning in geriatric dentistry].

    PubMed

    Le Guern, J Y

    1990-03-01

    In elderly patients, recurrent fractures of the lower denture must raise the question of a neurological deficit as cause of the occluso-prosthetic imbalance. Hypotonicity of the peri-oral mastication musculature, especially the masseters, may explain the alteration of the prosthetic supporting surface due to shriveling of the mandibular arch, along with an osseogenesis at the point of flexion of the mandible. The rest and activity muscular imbalance, resulting from unilateral mastication, may cause lingual dysfunction and deviation of the tongue at rest. If this problem is not controlled within an acceptable period of time, one should expect psychological, biological and physiological consequences affecting the patient's physical condition. The restoration of the denture fracture is insufficient. Reconditioning must be performed in order to replace the existing prosthesis in the patient's function, allowing him/her to recover a normal psychological, biological and physiological balance. In conclusion, in geriatric dentistry, the objective of reconditioning is, not only to restore a functional occlusion, but also the psychological, biological and physiological balance of the patient. This is an unvaluable advantage, especially if this contributes to maintain or restore an often precarious health. PMID:2200568

  17. [Analgesics in geriatric patients. Adverse side effects and interactions].

    PubMed

    Gosch, Markus

    2015-07-01

    Pain is a widespread symptom in clinical practice. Older adults and chronically ill patients are particularly affected. In multimorbid geriatric patients, pharmacological pain treatment is an extension of a previously existing multimedication. Besides the efficacy of pain treatment, drug side effects and drug-drug interactions have to be taken into account to minimize the health risk for these patients. Apart from the number of prescriptions, the age-related pharmacokinetic and pharmacodynamic changes significantly increase the risk among older adults. The use of non-steroidal anti-inflammatory drugs (NSAID) is widespread but NSAIDs have the highest risk of adverse drug reactions and drug interactions. In particular, the gastrointestinal, cardiovascular, renal and coagulation systems are affected. Apart from the known toxic effect on the liver (in high doses), paracetamol (acetaminophen) has similar risks although to a lesser degree. According to current data, metamizol is actually better than its reputation suggests. The risk of potential drug interactions seems to be low. Apart from the risk of sedation in combination with other drugs, tramadol and other opioids can induce the serotonin syndrome. Among older adults, especially in the case of polypharmacy, an individualized approach should be considered instead of sticking to the pain management recommended by the World Health Organization (WHO) in order to minimize drug-drug interactions and adverse drug reactions. PMID:26152872

  18. The 3 D's of geriatric psychiatry: depression, delirium, and dementia.

    PubMed

    Dharia, Sheetal; Verilla, Kailen; Breden, Ericka L

    2011-08-01

    A Caucasian female octogenarian with multiple medical problems was admitted to the inpatient geriatric psychiatry unit with intermittent altered mental status and decline in memory. She had been hospitalized four times in the previous three months. She was admitted on more than 10 medications and received more than 20 different medications in this time period. It was determined that she had delirium concurrent with dementia and/or depression. During her hospital stay a urinary tract infection (UTI) was treated, her anticholinergic medications were minimized, and her digoxin dose was adjusted. As her mental status cleared, a workup was completed to differentiate between dementia and depression. She was initially treated with memantine, but as time progressed it became more evident she was experiencing depression and a "pseudodementia," which was treated with sertraline. Her Mini-Mental State Examination returned to 29/30 (her score previously was 26/29). This case demonstrates the complexity of treating an elder individual and the importance of differentiating among delirium, depression, and dementia. The pharmacy team played an active role in medication reconciliation. Additionally, they worked with the medical team to minimize her potentially harmful medications and optimize the treatment of her UTI and depression. PMID:21840820

  19. A Geriatric Perspective on Benign Paroxysmal Positional Vertigo.

    PubMed

    Parham, Kourosh; Kuchel, George A

    2016-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common cause of vertigo in older adults. Beyond the unpleasant sensation of vertigo, BPPV also negatively affects older adults' gait and balance and increases their risk of falling. As such it has a profound effect on function, independence, and quality of life. Otoconia are the inner ear structures that help detect horizontal and vertical movements. Aging contributes to the fragmentation of otoconia, whose displacement into the semicircular, most commonly posterior canals, can produce rotatory movement sensations with head movement. BPPV is more commonly idiopathic in older adults than in younger individuals, can present atypically, and has a more-protracted course and higher risk of recurrence. Medications such as meclizine that are commonly prescribed for BPPV can be associated with significant side effects. Dix-Hallpike and Head Roll tests can generally identify the involved canal. Symptoms resolve as otoconia fragments dissolve into the endolymph, but appropriate canalith repositioning (e.g., Epley maneuver) can expedite recovery and reduce the burden of this disorder. Observations suggesting an association between idiopathic BPPV and vitamin D deficiency and osteoporosis indicate that BPPV may share risk factors with other common geriatric conditions, which highlights the importance of moving beyond purely otological considerations and addressing the needs of older adults with vertigo through a systems-based multidisciplinary approach. PMID:26804483

  20. Mortality meetings in geriatric medicine: strategies for improvement

    PubMed Central

    Dunbar, Joanne; George, James

    2015-01-01

    A large proportion of patients who die in hospital will be under the care of geriatric medicine. Mortality reviews have traditionally used trigger tools to try and identify preventable deaths, but the majority of hospital deaths are not preventable and lapses in care are often very complex. Over a period of 14 months we performed four PDSA cycles to change the focus of mortality meetings within care of the elderly and stroke medicine at Cumberland Infirmary to look beyond preventable deaths. The aim was to maximise learning from mortality meetings to improve patient care. We used collaborative working at a trust and departmental level, moving from trigger tool preparation to a narrative approach, and we set up strategies to focus and disseminate our learning. The mean number of cases discussed per meeting and the mean number of lessons identified per case discussed increased, as did the learning levels (trust, department, individual). Maintaining multidisciplinary input and consolidating lessons learnt was difficult because of clinical commitments and natural staff turnover. PMID:26734372

  1. Decrease in Antioxidant Status of Plasma and Erythrocytes from Geriatric Population

    PubMed Central

    Kumawat, Manjulata; Sharma, Tarun Kumar; Singh, Ishwar; Singh, Neelima; Singh, Sanjeev Kumar; Ghalaut, Veena Singh; Shankar, Vijay; Vardey, Satish Kumar

    2012-01-01

    Background: Ageing is associated with an accumulation of free radical damage, which leads to physiological and clinical modifications. The study aims to find out the status of lipid profile, antioxidant enzymes, malondialdehyde in geriatric population. Patients/methods: The study was conducted on 150 subjects (75 healthy control between the ages of 20–30 years and 75 elderly subjects between ages of 50–70 years as cases). The following parameters were analyzed using the standard reference methods: lipid profile, reduced glutathione, glutathione peroxidase, glutathione reductase, catalase, superoxide dismutase and malondialdehyde. Results: The present study was conducted to estimate the oxidative stress parameters in geriatric population. Highly significant increase in total cholesterol (TC), triglyceride (TG), LDL-cholesterol (LDL-C), VLDL-cholesterol (VLDL-C), malondialdehyde, catalase and decrease in high density lipoprotein cholesterol (HDL-C), reduced glutathione, glutathione peroxidase, glutathione reductase, superoxide dismutase was observed in geriatrics when compared with their younger counterparts. Conclusion: This study concluded that there is enhanced oxidative stress and decreased antioxidant defence in geriatrics as compared to younger subjects which could play an important role in ageing. Dyslipidemia has become one of the important risk factors for the increasing prevalence of cardiovascular diseases. There is lack of awareness on the relationship between blood lipids and the risk of cardiovascular diseases in geriatric population. The strategy of early prevention should be adopted against dyslipidemia. PMID:23089922

  2. Vital Signs Strongly Predict Massive Transfusion Need in Geriatric Trauma Patients.

    PubMed

    Fligor, Scott C; Hamill, Mark E; Love, Katie M; Collier, Bryan R; Lollar, Dan; Bradburn, Eric H

    2016-07-01

    Early recognition of massive transfusion (MT) requirement in geriatric trauma patients presents a challenge, as older patients present with vital signs outside of traditional thresholds for hypotension and tachycardia. Although many systems exist to predict MT need in trauma patients, none have specifically evaluated the geriatric population. We sought to evaluate the predictive value of presenting vital signs in geriatric trauma patients for prediction of MT. We retrospectively reviewed geriatric trauma patients presenting to our Level I trauma center from 2010 to 2013 requiring full trauma team activation. The area under the receiver operating characteristic curve was calculated to assess discrimination of arrival vital signs for MT prediction. Ideal cutoffs with high sensitivity and specificity were identified. A total of 194 patients with complete data were analyzed. Of these, 16 patients received MT. There was no difference between the MT and non-MT groups in sex, age, or mechanism. Systolic blood pressure, pulse pressure, diastolic blood pressure, and shock index all were strongly predictive of MT need. Interestingly, we found that heart rate does not predict MT. MT in geriatric trauma patients can be reliably and simply predicted by arrival vital signs. Heart rate may not reflect serious hemorrhage in this population. PMID:27457863

  3. Professional development and exposure to geriatrics: medical student perspectives from narrative journals.

    PubMed

    Shield, Renée R; Farrell, Timothy W; Campbell, Susan E; Nanda, Aman; Wetle, Terrie

    2015-01-01

    Teaching professionalism is an important goal in American medical education. With the aging of the U.S. population, it is critical to understand how medical students develop professional behaviors when caring for older adults. Exposure to geriatrics and older patients can enhance students' professional development with patients of all ages and across different specialties. Medical students learn explicit and implicit messages during their education. In addition to helping to evaluate curricula, reflective journaling encourages individual development and helps in revealing how medical students become professionals. In this study, medical student volunteers described their responses to new geriatrics content in their curriculum, encounters with older patients in clinical settings, and their evolving physician identities. Multidisciplinary team analysis elicited 10 themes regarding: evaluation of geriatrics within the curriculum, recognition of geriatrics principles, and attitudes regarding aging and professional development over time. This article focuses on the impact of geriatrics exposure on students' professional development, revealing ways that students think about professionalism and older patients. Medical educators should consider journaling to help foster and gauge students' professional development. PMID:25152977

  4. [Ambulatory geriatric rehabilitation and its legal classification within the statutory health insurance system].

    PubMed

    Plate, A; Meinck, M

    2005-08-01

    In Germany, the number and proportion of elderly people will continue to increase. Only few hospitals and rehabilitation units are currently providing inpatient geriatric services. Concepts for graded geriatric care see ambulatory geriatric rehabilitation (AGR) as an independent service und as a complement to pre-existing structures in geriatric care. In 2004, the national association of statutory health insurance funds established recommendations for AGR, which include criteria of structural and process quality of ambulant geriatric rehabilitation. This article describes various aspects of these framework recommendations (target groups, rehabilitation indicators, and equipment of services). In addition, the classification of AGR within the legislation of the statutory health insurance system is evaluated. The financing of AGR by the statutory health insurance system and the preconditions for accreditation of AGR-services within this system are discussed. The authors conclude that discrimination between existing partially-inpatient day clinics and AGR services is not appropriate. Furthermore, there is no legal basis for such a discrimination; on the contrary, the terms partially-inpatient and ambulatory rehabilitation services can be seen as a uniform benefit according to book 5 of the German social code, SGB V. Therefore there is no differentiation between AGR and partially-inpatient rehabilitation in the statutory health insurance system. PMID:16059839

  5. Geriatric assessment to predict survival in older allogeneic hematopoietic cell transplantation recipients

    PubMed Central

    Muffly, Lori S.; Kocherginsky, Masha; Stock, Wendy; Chu, Quynh; Bishop, Michael R.; Godley, Lucy A.; Kline, Justin; Liu, Hongtao; Odenike, Olatoyosi M.; Larson, Richard A.; van Besien, Koen; Artz, Andrew S.

    2014-01-01

    Allogeneic hematopoietic cell transplantation is increasingly utilized in older adults. This study prospectively evaluated the prognostic utility of geriatric assessment domains prior to allogeneic transplantation in recipients aged 50 years and over. Geriatric assessment was performed prior to transplant, and included validated measures across domains of function and disability, comorbidity, frailty, mental health, nutritional status, and systemic inflammation. A total of 203 patients completed geriatric assessment and underwent transplant. Median age was 58 years (range 50–73). After adjusting for established prognostic factors, limitations in instrumental activities of daily living (HR 2.38, 95%CI: 1.59–3.56; P<0.001), slow walk speed (HR 1.80, 95%CI: 1.14–2.83; P=0.01), high comorbidity by hematopoietic cell transplantation-specific comorbidity index (HR 1.56, 95%CI: 1.07–2.28; P=0.02), low mental health by short-form-36 mental component summary (HR 1.67, 95%CI: 1.13–2.48; P=0.01), and elevated serum C-reactive protein (HR 2.51, 95%CI: 1.54–4.09; P<0.001) were significantly associated with inferior overall survival. These associations were more pronounced in the cohort 60 years and over. Geriatric assessment measures confer independent prognostic utility in older allogeneic transplant recipients. Implementation of geriatric assessment prior to allogeneic transplantation may aid appropriate selection of older adults. PMID:24816237

  6. Private nursing homes: contribution to long stay care of the elderly in the Brighton Health District.

    PubMed Central

    Bennett, J

    1986-01-01

    Two surveys of private nursing homes, designated geriatric wards, and a sample of social service part III homes were carried out in the Brighton Health District using questionnaires supplemented (in the second survey) by some interviews. The dependency of old people in the private nursing homes was more like that of long stay hospital patients rather than that of residents in social services homes. In the private nursing homes, however, a smaller proportion of patients were in the medium to heavy nursing category (178 (31%) compared with 158 (63%) in the hospital long stay wards) and a larger proportion in the heavy nursing category (170 (30%) compared with 44 (17%) in the long stay wards). Of the patients in private nursing homes, 401 (82%) were local residents, 488 (86%) were long stay, and 459 (88%) were women; their mean age was 88 years. Two thirds of the patients were over 80. There were no significant differences between the private nursing homes and the wards in nursing workloads or staffing, except for a slightly higher provision of state registered nurses in the private sector. In the private nursing homes 348 (63%) of the patients had fees paid by private funds, 26 (5%) were in contract beds paid for by the National Health Service, and 176 (32%) were subsidized by the Department of Health and Social Security. Private nursing homes make a substantial contribution to the care of the elderly in the Brighton Health District, and the health authority should develop a more active partnership with this sector. PMID:3094690

  7. Psychotropic Medication Use among Older Adults: What All Nurses Need to Know

    PubMed Central

    Lindsey, Pamela L

    2011-01-01

    Psychotropic medications are commonly administered to elderly clients to manage behavior and psychiatric symptoms. These drugs are known to have potentially serious side effects, to which older adults are more vulnerable. Nurses care for older adults in many different practice settings but have varying degrees of knowledge about these kinds of medications. The purposes of this article are to (a) provide information to geriatric nurses in all settings about how the most commonly prescribed psychotropic medications (i.e., anxiolytic, antidepressant, and antipsychotic drugs) differentially affect older adults; (b) examine recent concerns about the use of psychotropic medications with older adults; and (c) discuss nursing implications for those administering psychotropic medications to older adults. PMID:19715261

  8. What nurses want: the nurse incentives project.

    PubMed

    Wieck, K Lynn; Dols, Jean; Northam, Sally

    2009-01-01

    Today's nurse executives are struggling with leadership challenges of managing the multigenerational workforce, financial imperatives to deliver better care for lower costs, and competition to provide the optimal work environment to retain nurses. The purpose of the Nurse Incentives Project was to determine satisfaction with current employment incentives and potential managerial actions which might decrease or delay turnover by registered nurses. This study spawned recommendations regarding the role of incentives in designing an environment where benefits and perks will be seen as incentives to stay and thrive in the current nursing workplace. The results show that nurses know what they want. Attention to generational priorities and flexible benefits programs may help to create the cohesive work environment that nurses seek. Investment into creating delivery arenas where satisfied nurses are caring for satisfied patients is a worthwhile goal. PMID:19558077

  9. Nursing Jobs in Nursing Homes

    ERIC Educational Resources Information Center

    Torpey, Elka Maria

    2011-01-01

    The need for practical nurses who focus on caring for older people is growing. According to the U.S. Census Bureau, the number of people ages 65 and older is expected to increase from 40 million to 72 million between 2010 and 2030. And the U.S. Bureau of Labor Statistics (BLS) projects that this increasing population will result in job growth for…

  10. Development and Evaluation of a Longitudinal Case-Based Learning (CBL) Experience for a Geriatric Medicine Rotation

    ERIC Educational Resources Information Center

    Struck, Bryan D.; Teasdale, Thomas A.

    2008-01-01

    The DWR Department of Geriatric Medicine at OUHSC and the OKC VA Medical Center began a mandatory third-year geriatric medicine clerkship in 2003. As part of the didactic sessions, the Department created a longitudinal Case-Based Learning (CBL) experience. The purpose of this paper is to describe the CBL experience, report student satisfaction…

  11. The Geriatric Interdisciplinary Team Approach: Challenges and Opportunities in Educating Trainees together from a Variety of Disciplines.

    ERIC Educational Resources Information Center

    Mellor, M. Joanna; Hyer, Kathryn; Howe, Judith L.

    2002-01-01

    Health care workers at eight sites were trained to serve on interdisciplinary geriatric care teams. Challenges included differing levels of experience and geriatric knowledge, discipline specific-language and practice philosophies, and scheduling conflicts. Techniques to overcome them included case studies, standardized patients, cross-discipline…

  12. Nursing, knowledge and practice.

    PubMed

    Allen, D

    1997-07-01

    Recent commentators have suggested that academic knowledge is irrelevant to nursing practice and may actually undermine nursing's traditional caring ethos. Furthermore, by making nursing more academic, it is claimed that 'natural' but non-academic carers are prevented from pursuing a career in nursing. Debates about the relationship between nursing, knowledge and practice have a long history and have to be understood in terms of wider political and economic issues relating to nursing, its status within society and the changing role of nurses within the health services division of labour. One crucial issue is nursing's status as women's work. Critics of developments in nurse education draw an ideological equation between nursing work and the traditional female role. From this perspective the qualities that make a good nurse cannot be taught, rather they are founded on 'natural' feminine skills. Irrespective of whether caring is 'natural' or not, it is questionable as to whether, for today's nurses, being caring is sufficient. The shape of nursing jurisdiction is a long way removed from its origins in the Victorian middle-class household. In addition to their traditional caring role, contemporary nurses may also have complex clinical, management and research responsibilities, as well as being crucial coordinators of service provision. It is suggested that these and future developments in health services make the need for an educated nursing workforce even more pressing. In order to adequately prepare nurses for practice, however, it is vital that nurse education reflects the reality of service provision. PMID:10180381

  13. Parish nursing: an innovative community nursing service.

    PubMed

    Laming, Eleanor; Stewart, Angela

    2016-07-13

    This article explains the concept of parish nursing and provides a historical perspective of this service. It describes the development of a parish nursing service in Heartsease, Norwich, which complements community nursing practice by focusing on the importance of providing spiritual care alongside physical, psychological and social care. Case studies are provided to illustrate the benefits of a parish nursing service to individuals and the community. PMID:27406519

  14. Professional Transition: Nurse to Nurse-Midwife

    ERIC Educational Resources Information Center

    Mulligan, Joan E.

    1976-01-01

    The article focuses on one nurse's experience in the nurse-midwife program at a large New York medical center. Terming the learning process a painful transition from academe to reality, the author discusses skills learned, conflicts with physicians' belief systems, rewards and frustrations, and the need for nurse-midwife identity. (Author/MS)

  15. Nursing 302: An Introduction to Psychiatric Nursing.

    ERIC Educational Resources Information Center

    Blaustein, Jenna Rose

    A description is provided of "Introduction to Psychiatric Nursing," a 7-week course offered to juniors and seniors in a bachelor of science nursing program. The first sections present information on curricular placement, time assignments, and the targeted student population, and define psychiatric/mental health nursing. Next, the course…

  16. Update for 2014 on clinical cardiology, geriatric cardiology, and heart failure and transplantation.

    PubMed

    Barón-Esquivias, Gonzalo; Manito, Nicolás; López Díaz, Javier; Martín Santana, Antonio; García Pinilla, José Manuel; Gómez Doblas, Juan José; Gómez Bueno, Manuel; Barrios Alonso, Vivencio; Lambert, José Luis

    2015-04-01

    In the present article, we review publications from the previous year in the following 3 areas: clinical cardiology, geriatric cardiology, and heart failure and transplantation. Among the new developments in clinical cardiology are several contributions from Spanish groups on tricuspid and aortic regurgitation, developments in atrial fibrillation, syncope, and the clinical characteristics of heart disease, as well as various studies on familial heart disease and chronic ischemic heart disease. In geriatric cardiology, the most relevant studies published in 2014 involve heart failure, degenerative aortic stenosis, and data on atrial fibrillation in the geriatric population. In heart failure and transplantation, the most noteworthy developments concern the importance of multidisciplinary units and patients with preserved systolic function. Other notable publications were those related to iron deficiency, new drugs, and new devices and biomarkers. Finally, we review studies on acute heart failure and transplantation, such as inotropic drugs and ventricular assist devices. PMID:25758161

  17. Development and implementation of a geriatric care/case management program in a military community-based family medicine residency.

    PubMed

    Williams, C M; Petrelli, J; Murphy, M

    2000-11-01

    This article discusses how the development of a longitudinal geriatric assessment form facilitated a case management program in identifying high-risk frail elders within a military family practice clinic. A careful review of geriatric assessment tools was performed. From this review, a model geriatric assessment form was developed. A "SWOT" (strengths, weaknesses, opportunities, and threats) analysis of the family medicine department was completed to determine if the environment was ready for case management. Analysis of the SWOT data revealed that the environment was favorable for a population-based approach to case management. Results of this initial study are encouraging. The new longitudinal geriatric assessment form has assisted family practice residents in organizing problems and data while seeing elderly patients. As a direct result, higher-risk frail elders have been identified for closer evaluation and follow-up. Future goals are to measure outcomes-based data and to refine the geriatric assessment process. PMID:11143424

  18. Educational needs, practice patterns and quality indicators to improve geriatric pharmacy care

    PubMed Central

    Zou, Dan

    2014-01-01

    Background: As the population ages and pressure increases to reduce adverse drug reactions and drug-related hospitalizations in the elderly, there will be a growing demand for pharmacists to competently take on shared responsibility for effective and safe prescribing in older adults. Methods: A cross-sectional postal survey was distributed to 3927 hospital and community pharmacists across Québec about their educational needs and practice patterns in geriatric care. Perceptions of different quality performance indicators were sought. Modifiable factors associated with higher performance were determined using univariate logistic regression. Results: Seven hundred six pharmacists (18%) completed the survey. Less than 50% were aware of the prevalence of polypharmacy, inappropriate prescribing, drug-related hospitalizations or falls in the geriatric population. Forty-one percent of community pharmacists and 74% of hospital pharmacists acknowledged familiarity with the Beers criteria of drugs to avoid in the elderly. The likelihood of screening for inappropriate prescriptions was 2.96 (95% confidence interval = 1.97-4.47) among pharmacists familiar with the Beers criteria and 2.24 (95% confidence interval = 1.50-3.34) among those who received continuing geriatric education in the workplace. On average, pharmacists reported having time to conduct detailed medication reviews in 30% of their older patients. The 2 quality indicators of geriatric care that were ranked most pertinent were being able to track the number of patients requiring hospitalization for drug-related problems and monitoring rates of inappropriate prescriptions. Ninety-six percent of respondents desired continuing education about geriatric care. Conclusion: Exposure to continuing education in geriatric pharmacotherapy in the workplace is the most consistent determinant of professional performance to improve drug outcomes in the elderly. PMID:24660011

  19. Multimorbidity Patterns in Hospitalized Older Patients: Associations among Chronic Diseases and Geriatric Syndromes

    PubMed Central

    Clerencia-Sierra, Mercedes; Calderón-Larrañaga, Amaia; Martínez-Velilla, Nicolás; Vergara-Mitxeltorena, Itziar; Aldaz-Herce, Pablo; Poblador-Plou, Beatriz; Machón-Sobrado, Mónica; Egüés-Olazabal, Nerea; Abellán-van Kan, Gabor; Prados-Torres, Alexandra

    2015-01-01

    Background/Objectives The clinical status of older individuals with multimorbidity can be further complicated by concomitant geriatric syndromes. This study explores multimorbidity patterns, encompassing both chronic diseases and geriatric syndromes, in geriatric patients attended in an acute hospital setting. Design Retrospective observational study. Setting Unit of Social and Clinical Assessment (UVSS), Miguel Servet University Hospital (HUMS), Zaragoza (Spain). Year, 2011. Participants A total of 924 hospitalized patients aged 65 years or older. Measurements Data on patients’ clinical, functional, cognitive and social statuses were gathered through comprehensive geriatric assessments. To identify diseases and/or geriatric syndromes that cluster into patterns, an exploratory factor analysis was applied, stratifying by sex. The factors can be interpreted as multimorbidity patterns, i.e., diseases non-randomly associated with each other within the study population. The resulting patterns were clinically assessed by several physicians. Results The mean age of the study population was 82.1 years (SD 7.2). Multimorbidity burden was lower in men under 80 years, but increased in those over 80. Immobility, urinary incontinence, hypertension, falls, dementia, cognitive decline, diabetes and arrhythmia were among the 10 most frequent health problems in both sexes, with prevalence rates above 20%. Four multimorbidity patterns were identified that were present in both sexes: Cardiovascular, Induced Dependency, Falls and Osteoarticular. The number of conditions comprising these patterns was similar in men and women. Conclusion The existence of specific multimorbidity patterns in geriatric patients, such as the Induced Dependency and Falls patterns, may facilitate the early detection of vulnerability to stressors, thus helping to avoid negative health outcomes such as functional disability. PMID:26208112

  20. Delirium in the geriatric unit: proton-pump inhibitors and other risk factors

    PubMed Central

    Otremba, Iwona; Wilczyński, Krzysztof; Szewieczek, Jan

    2016-01-01

    Background Delirium remains a major nosocomial complication of hospitalized elderly. Predictive models for delirium may be useful for identification of high-risk patients for implementation of preventive strategies. Objective Evaluate specific factors for development of delirium in a geriatric ward setting. Methods Prospective cross-sectional study comprised 675 consecutive patients aged 79.2±7.7 years (66% women and 34% men), admitted to the subacute geriatric ward of a multiprofile university hospital after exclusion of 113 patients treated with antipsychotic medication because of behavioral disorders before admission. Comprehensive geriatric assessments including a structured interview, physical examination, geriatric functional assessment, blood sampling, ECG, abdominal ultrasound, chest X-ray, Confusion Assessment Method for diagnosis of delirium, Delirium-O-Meter to assess delirium severity, Richmond Agitation-Sedation Scale to assess sedation or agitation, visual analog scale and Doloplus-2 scale to assess pain level were performed. Results Multivariate logistic regression analysis revealed five independent factors associated with development of delirium in geriatric inpatients: transfer between hospital wards (odds ratio [OR] =2.78; confidence interval [CI] =1.54–5.01; P=0.001), preexisting dementia (OR =2.29; CI =1.44–3.65; P<0.001), previous delirium incidents (OR =2.23; CI =1.47–3.38; P<0.001), previous fall incidents (OR =1.76; CI =1.17–2.64; P=0.006), and use of proton-pump inhibitors (OR =1.67; CI =1.11–2.53; P=0.014). Conclusion Transfer between hospital wards, preexisting dementia, previous delirium incidents, previous fall incidents, and use of proton-pump inhibitors are predictive of development of delirium in the geriatric inpatient setting. PMID:27103793

  1. High-Energy Proximal Femur Fractures in Geriatric Patients

    PubMed Central

    Hahnhaussen, Jens; Hak, David J; Weckbach, Sebastian; Ertel, Wolfgang; Stahel, Philip F

    2011-01-01

    Background: There is limited information in the literature on the outcomes and complications in elderly patients who sustain high-energy hip fractures. As the population ages, the incidence of high-energy geriatric hip fractures is expected to increase. The purpose of this study was to analyze the outcomes and complications in patients aged 65 years or older, who sustained a high-energy proximal femur fracture. Methods: Retrospective review of a prospective trauma database from January 2000 to April 2011 at a single US academic level-1 trauma center. Inclusion criteria consisted of all patients of age 65 years or older, who sustained a proximal femur fracture related to a high-energy trauma mechanism. Details concerning injury, acute treatment, and clinical course and outcome were obtained from medical records and radiographs. Results: We identified 509 proximal femur fractures in patients older than 65 years of age, of which 32 (6.3%) were related to a high-energy trauma mechanism. The mean age in the study group was 72.2 years (range 65-87), with a mean injury severity score of 20 points (range 9-57). Three patients died before discharge (9.4%), and 22 of 32 patients sustained at least one complication (68.8%). Blunt chest trauma represented the most frequently associated injury, and the main root cause of pulmonary complications. The patients' age and comorbidities did not significantly correlate with the rate of complications and the 1-year mortality. Conclusions: High-energy proximal femur fractures in elderly patients are not very common and are associated with a low in-hospital mortality rate of less than 10%, despite high rate of complications of nearly 70%. This selective cohort of patients requires a particular attention to respiratory management due to the high incidence of associated chest trauma. PMID:23569690

  2. Cardiovascular nursing in Israel.

    PubMed

    Blaer, Yosef; Rosenberg, Orit; Reisin, Leonardo

    2003-01-01

    Cardiovascular (CV) nursing as an entity in Israel dates back to 1952, when the nurses in Tel-Hashomer hospital took care of postoperative heart surgery patients. The first intensive cardiac care units (ICCUs) were established in 1971. In 1982, the first ICCU course was established in Tel-Hashomer hospital nursing school. Today, most of the nursing staff in Israels ICCUs are graduates of ICCU courses. The nurses professional society, the Society for Nursing of Israel, was established in 1947. In 1989 the Society for Advancement of Cardiac Nursing in Israel (SACN) was established. The main goals of the society were: the exchange of CV nursing knowledge, CV nursing research, CV nursing education in nursing schools, education of nurses in other departments in the care of the cardiac patient, and CV nursing education in the community. The CV nurse takes a large role in the total care of the cardiac patient, which includes rehabilitation within the hospital and in the ambulatory setting and coordination of nursing in national and international multicenter clinical trials. In collaboration with the Ministry of Health Nursing Division, Israeli CV nurses participate in national and international projects to: develop and upgrade nursing education; train new CV nurses; develop, review, and revise nursing protocols and guidelines; and establish new, more advanced ICCUs in underdeveloped areas within Israel and around the world. Our vision for the future development of CV nursing in Israel includes coordination and management roles in the hospital setting, and the establishment and management of home-care programs. PMID:12624572

  3. Exploring the Realities of Curriculum-by-Random-Opportunity: The Case of Geriatrics on the Internal Medicine Clerkship Rotation

    PubMed Central

    Diachun, Laura; Charise, Andrea; Goldszmidt, Mark; Hui, Yin; Lingard, Lorelei

    2014-01-01

    Background While major clerkship blocks may have objectives related to specialized areas such as geriatrics, gay and lesbian bisexual transgender health, and palliative care, there is concern that teaching activities may not attend sufficiently to these objectives. Rather, these objectives are assumed to be met “by random opportunity”.(1) This study explored the case of geriatric learning opportunities on internal medicine clinical teaching units, to better understand the affordances and limitations of curriculum by random opportunity. Methods Using audio-recordings of morning case review discussions of 13 patients > 65 years old and the Canadian geriatric core competencies for medical students, we conducted a content analysis of each case for potential geriatric and non-geriatric learning opportunities. These learning opportunities were compared with attendings’ case review teaching discussions. The 13 cases contained 40 geriatric-related and 110 non-geriatric-related issues. While many of the geriatric issues (e.g., delirium, falls) were directly relevant to the presenting illness, attendings’ teaching discussions focused almost exclusively on non-geriatric medical issues, such as management of diabetes and anemia, many of which were less directly relevant to the reason for presenting to hospital. Results The authors found that the general medicine rotation provides opportunities to acquire geriatric competencies. However, the rare uptake of opportunities in this study suggests that, in curriculum-by-random-opportunity, presence of an opportunity does not justify the assumption that learning objectives will be met. Conclusions More studies are required to investigate whether these findings are transferrable to other vulnerable populations about which undergraduate students are expected to learn through curriculum by random opportunity. PMID:25452825

  4. Nurses' Attitudes towards Alcoholics.

    ERIC Educational Resources Information Center

    Speer, Rita D.

    Nurses' attitudes toward the alcoholic can have a profound impact on the person suffering from alcoholism. These attitudes can affect the alcoholic's care and even whether the alcoholic chooses to recover. This study investigated attitudes of approximately 68 nurses employed in hospitals, 49 nurses in treatment facilities, 58 nursing students, and…

  5. Nursing's Image on Campus.

    ERIC Educational Resources Information Center

    Woolley, Alma S.

    1981-01-01

    In studying the nurse's image at a liberal arts college, it was found that faculty and administrators view nurses as long-suffering drones. On the whole, the image of nursing was positive, with those who had the most contact with the nursing program having a more enlightened image. (CT)

  6. Geriatric orthopedic co-management of older adults with hip fracture: an emerging standard

    PubMed Central

    Chen, Pei

    2015-01-01

    Hip fracture, a common complication of fall injuries in older adults, often results in high rate of mortality, increased debility, functional loss, and worse quality of life. The value of geriatric teams and model of care for the hip fracture patients have been examined in a number of studies, and even though most studies have demonstrated potential impact in improving outcomes for the hip fracture patients, they are often observational or quasi-experimental designs that are prone to bias. In this editorial, we review the Lancet article by Prestmo and colleagues, a randomized controlled trial that demonstrated improved outcomes for hip fracture patients managed in a geriatric unit. PMID:26539441

  7. Measuring Nursing Care Value.

    PubMed

    Welton, John M; Harper, Ellen M

    2016-01-01

    The value of nursing care as well as the contribution of individual nurses to clinical outcomes has been difficult to measure and evaluate. Existing health care financial models hide the contribution of nurses; therefore, the link between the cost and quality o nursing care is unknown. New data and methods are needed to articulate the added value of nurses to patient care. The final results and recommendations of an expert workgroup tasked with defining and measuring nursing care value, including a data model to allow extraction of key information from electronic health records to measure nursing care value, are described. A set of new analytic metrics are proposed. PMID:27055306

  8. Recommendations From the International Consortium on Professional Nursing Practice in Long-Term Care Homes.

    PubMed

    McGilton, Katherine S; Bowers, Barbara J; Heath, Hazel; Shannon, Kay; Dellefield, Mary Ellen; Prentice, Dawn; Siegel, Elena O; Meyer, Julienne; Chu, Charlene H; Ploeg, Jenny; Boscart, Veronique M; Corazzini, Kirsten N; Anderson, Ruth A; Mueller, Christine A

    2016-02-01

    In response to the International Association of Gerontology and Geriatrics' global agenda for clinical research and quality of care in long-term care homes (LTCHs), the International Consortium on Professional Nursing Practice in Long Term Care Homes (the Consortium) was formed to develop nursing leadership capacity and address the concerns regarding the current state of professional nursing practice in LTCHs. At its invitational, 2-day inaugural meeting, the Consortium brought together international nurse experts to explore the potential of registered nurses (RNs) who work as supervisors or charge nurses within the LTCHs and the value of their contribution in nursing homes, consider what RN competencies might be needed, discuss effective educational (curriculum and practice) experiences, health care policy, and human resources planning requirements, and to identify what sustainable nurse leadership strategies and models might enhance the effectiveness of RNs in improving resident, family, and staff outcomes. The Consortium made recommendations about the following priority issues for action: (1) define the competencies of RNs required to care for older adults in LTCHs; (2) create an LTCH environment in which the RN role is differentiated from other team members and RNs can practice to their full scope; and (3) prepare RN leaders to operate effectively in person-centered care LTCH environments. In addition to clear recommendations for practice, the Consortium identified several areas in which further research is needed. The Consortium advocated for a research agenda that emphasizes an international coordination of research efforts to explore similar issues, the pursuit of examining the impact of nursing and organizational models, and the showcasing of excellence in nursing practice in care homes, so that others might learn from what works. Several studies already under way are also described. PMID:26712302

  9. User Expectations: Nurses' Perspective.

    PubMed

    Gürsel, Güney

    2016-01-01

    Healthcare is a technology-intensive industry. Although all healthcare staff needs qualified computer support, physicians and nurses need more. As nursing practice is an information intensive issue, understanding nurses' expectations from healthcare information systems (HCIS) is a must issue to meet their needs and help them in a better way. In this study perceived importance of nurses' expectations from HCIS is investigated, and two HCIS is evaluated for meeting the expectations of nurses by using fuzzy logic methodologies. PMID:27332398

  10. Professional Behavior in Nursing.

    PubMed

    Kowalski, Karren

    2016-04-01

    Being clear about what constitutes professional behavior is a pathway to effective leadership. Not all nurses come out of educational programs with an understanding about what aspects of behavior signal true professionalism. This article uses the American Organization of Nurse Executives' Nurse Executive Competency for Processional Behavior to help professional development nurse faculty identify role modeling behavior and other aspects that new nurses can use to help them advance in their careers, while improving care to patients and families. PMID:27031029

  11. Nursing in Turkey.

    PubMed

    Baumann, Steven L

    2006-10-01

    The current discussion on the nursing shortage needs to focus as much on nursing job satisfaction and retention as on nursing recruitment and education. Selected aspects of the motivational psychology of Abraham Maslow, Mihaly Csikszentmihalyi, and Frederick Hertzberg are here discussed in light of the challenges-opportunities of nursing in Turkey and elsewhere. Also discussed is an innovative program to support the application of nursing theory and professional development in Toronto, Canada. PMID:16982724

  12. Age-related geriatric medicine: relevance of special skills of geriatric medicine to elderly people admitted to hospital as medical emergencies.

    PubMed Central

    Kafetz, K; O'Farrell, J; Parry, A; Wijesuriya, V; McElligott, G; Rossiter, B; Lugon, M

    1995-01-01

    This study was carried out to find out how many patients aged 75 and over admitted to hospital as medical emergencies had features appropriate to care by physicians in geriatric medicine and to examine the extent of use of specialist facilities by these patients. The purpose was to examine criticisms of age-related admission policies which have focused on misplacement of patients with single diagnoses and lack of access to specialist care. An analysis was made of admission, process and discharge characteristics relevant to the special skills of geriatric medicine, multiple pathology and use of specialist services by 554 patients aged 75 and over. These were collected prospectively, consecutively admitted as medical emergencies via the accident and emergency department of a large district general hospital with an age-related (75 and over) medical admissions policy. 84 patients (15%) had single pathology and no characteristics suggesting the need for specialist geriatric care. 177 (32%) had single pathology and one or more specialized characteristics. 66 (12%) had multiple pathology alone. 227 (41%) had multiple pathology and specialized characteristics. There were 142 specialist referrals in 121 patients (22% of the whole sample). We concluded that the special skills of general physicians specializing in the medical and associated community problems of elderly people are highly relevant to patients aged 75 and over presenting as medical emergencies. There was no evidence of lack of involvement of specialists in their care. PMID:8544147

  13. Optimal Stroke Prevention in the Geriatric Patient with Atrial Fibrillation: Position Paper of an Interdisciplinary Expert Panel.

    PubMed

    Bahrmann, P; Wehling, M; Ropers, D; Flohr, J; Leischker, A; Röther, J

    2015-10-01

    The present position paper summarises the outcomes of an expert panel discussion held by hospital-based and office-based physicians with ample experience in the treatment of geriatric patients. The optimal approach to stroke prevention in geriatric patients with atrial fibrillation (AF) has not been adequately clarified. Despite their high risk of stroke and clear indication for anticoagulation according to established risk scores, in practice geriatric AF patients often are withheld treatment because of comorbidities and comedications, concerns about low treatment adherence or fear of bleeding events, in particular due to falls. The panel agreed that geriatric patients should receive oral anticoagulation as a rule, unless a comprehensive neurological and geriatric assessment (including clinical examination, gait tests and validated instruments such as Modified Rankin Scale, Mini-mental state examination or Timed Test of Money Counting) provides sound reasons for refraining from treatment. All patients with a history of falls should be thoroughly evaluated for further evaluation of the causes. Patients with CHADS2 score ≥ 2 should receive anticoagulation even if at high risk for falls. The novel oral anticoagulants (NOAC) facilitate management in the geriatric population with AF (no INR monitoring needed, easier bridging during interventions) and have, based on available data, an improved benefit-risk ratio compared to vitamin K antagonists. Drugs with predominantly non-renal elimination are safer in geriatric patients and should be preferred. PMID:25285794

  14. Value of intensified nursing

    PubMed Central

    Frank, Wilhelm; Konta, Brigitte; Prusa, Nina; Raymann, Cornelia

    2006-01-01

    The concept "intensified nursing" is mentioned in differentiation to concepts of "nursing care" or "nursing" which intensifies resources or patient contact. Especially psychic and social needs of patients are very appreciated in nursing. A similar type of nursing is known under the concept "advanced nursing practice" (ANP) which means, that a specialised, academically trained nurse offers an extended nursing care in which a focus on the published knowledge of evidence based research is made. From the thin literature to this topic a selection of predetermined topics was analysed where at least two articles with a sufficient high methodical quality were available. The selected topic groups were: „Infant and paediatric nursing", "gerontology" and "oncology". Generally the five publications concerning infant and paediatric nursing could conclusive show a benefit of intensified nursing. Further research is still needed to prove intensified nursing care. Two publications could be found to the gerontological intensified nursing; both used an extended nursing model and an enlarged use of resources. Both studies demonstrated a measurable success in the applied parameters. Two studies also could be analysed in the oncological field in which successes were also provable by the applied parameters. The success was given especially in a higher patient satisfaction, one study showed an improved scheduling (time planning) of nurses. There was not one article concerning economic questions of intensified nursing care. It has to be taken into account that the financial resources have to be used effectively also in nursing nowadays. It has to be assumed that the costs are driven by increased use of resources. Savings can be achieved, however, in the form of avoided therapies and days in hospital by intensified nursing. The intensified nursing can be considered as similar cost-effective as conventional models of nursing. Ethically it is necessary to consider that the possibilities of

  15. Geriatric Rehabilitation ('Alters-Rehabilitation'): The New Challenge for Social Medicine and Science.

    ERIC Educational Resources Information Center

    Barolin, G. S.

    1996-01-01

    This discussion of geriatric rehabilitation stresses the importance of holistic and permanent rehabilitation with a fluent transition from the acute phase to the rehabilitation phase under one specialist's care and in one institution. Recommendations include mixed age groups in one ward; systematic education of relatives; follow-up rehabilitation…

  16. Using a Geriatric Mentoring Narrative Program to Improve Medical Student Attitudes towards the Elderly

    ERIC Educational Resources Information Center

    Duke, Pamela; Cohen, Diane; Novack, Dennis

    2009-01-01

    This study examined first-year medical student attitudes concerning the elderly before and after instituting a geriatric mentoring program. The program began and ended with a survey designed to assess students' attitudes toward the elderly. During the mentoring program, students visited the same senior for four visits throughout the academic year.…

  17. Interdisciplinary Collaboration in Gerontology and Geriatrics in Latin America: Conceptual Approaches and Health Care Teams

    ERIC Educational Resources Information Center

    Gomez, Fernando; Curcio, Carmen Lucia

    2013-01-01

    The underlying rationale to support interdisciplinary collaboration in geriatrics and gerontology is based on the complexity of elderly care. The most important characteristic about interdisciplinary health care teams for older people in Latin America is their subjective-basis framework. In other regions, teams are organized according to a…

  18. Training Clinicians for Geriatric Practice: The Value of Qualitative Research Experience.

    ERIC Educational Resources Information Center

    Sassen, Georgia

    1986-01-01

    Suggests using the paradigm of qualitative research, consistent with the bio-psycho-social perspective, rather than the "rule out" decision-tree method of diagnosis for training in geriatrics. Argues that this paradigm would provide clinicians with the broadest picture of the presented problem. (Author/ABB)

  19. The Impact of VA's Geriatric Research, Education and Clinical Centers on Academic Affiliates

    ERIC Educational Resources Information Center

    Bragg, Elizabeth J.; Meganathan, Karthikeyan; Shay, Kenneth; Gilman, Stuart C.; Zeiss, Robert A.; Hettler, Debbie L.

    2011-01-01

    The education mission of the Department of Veterans Affairs (VA) is to train health professionals to benefit VA and the United States. One approach for achieving that mission, along with VA's research and clinical missions, was the establishment of Geriatric Research, Education and Clinical Centers (GRECCs) in 1975. These were developed at VA…

  20. 75 FR 11638 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-03-11

    ... Affairs and the Under Secretary for Health on all matters pertaining to geriatrics and gerontology. The Committee assesses the capability of VA health care facilities and programs to meet the medical... training, recruitment and retention approaches), Veterans Health Administration (VHA) strategic...

  1. Interdisciplinary Educational Approaches to Promote Team-Based Geriatrics and Palliative Care

    ERIC Educational Resources Information Center

    Howe, Judith L.; Sherman, Deborah Witt

    2006-01-01

    Despite the increasing public demand for enhanced care of older patients and those with life-threatening illness, health professionals have had limited formal education in geriatrics and palliative care. Furthermore, formal education in interdisciplinary team training is limited. In order to remedy this situation, proactive interventions are being…

  2. Simulating Geriatric Home Safety Assessments in a Three-Dimensional Virtual World

    ERIC Educational Resources Information Center

    Andrade, Allen D.; Cifuentes, Pedro; Mintzer, Michael J.; Roos, Bernard A.; Anam, Ramanakumar; Ruiz, Jorge G.

    2012-01-01

    Virtual worlds could offer inexpensive and safe three-dimensional environments in which medical trainees can learn to identify home safety hazards. Our aim was to evaluate the feasibility, usability, and acceptability of virtual worlds for geriatric home safety assessments and to correlate performance efficiency in hazard identification with…

  3. Overview of Geriatric Distance Education for Academic Courses and Continuing Education

    ERIC Educational Resources Information Center

    Johnson, Helen Arleen

    2004-01-01

    Distance education technologies may be applied to academic settings, continuing education/continuing medical education settings or in combination to both. This article provides an overview of what we have learned about academic and continuing education/continuing medical education in geriatrics and gerontology. It includes information on the scope…

  4. Integrating Geriatric Content into a Medical School Curriculum: Description of a Successful Model

    ERIC Educational Resources Information Center

    Newell, Debra A.; Raji, Mukaila; Lieberman, Steven; Beach, Robert E.

    2004-01-01

    Most medical school curricula do not equip students with adequate attitudes, knowledge and skills to care for elderly populations. We describe an effective geriatric curricular infusion model compatible with preserving the overall curricula schema. Course and clerkship directors, staff and faculty from the Office of Educational Development, Center…

  5. South Winnipeg Integrated Geriatric Program (SWING): A Rapid Community-Response Program for the Frail Elderly

    ERIC Educational Resources Information Center

    Montgomery, Patrick R.; Fallis, Wendy M.

    2003-01-01

    The objective of this study was to compare enhanced access to geriatric assessment and case management to usual home care service provision for the frail elderly. This was a demonstration project, with randomized allocation to control or intervention groups of frail elderly persons who had been referred to the Home Care service in Winnipeg. Of the…

  6. Development of a Geriatric Scale of Hopelessness: Implications for Counseling and Intervention with the Depressed Elderly.

    ERIC Educational Resources Information Center

    Fry, P. S.

    1984-01-01

    Evaluated hopelessness, depression, and self-esteem among depressed elderly people (N=78) and developed a Geriatric Hopelessness Scale (GHS). As predicted, elderly subjects who scored high on the GHS showed significantly higher depression and lower self-esteem scores. (JAC)

  7. Needs for CME in geriatrics. Part 1: Perceptions of patients and community informants.

    PubMed Central

    Pereles, L.; Russell, M. L.

    1996-01-01

    OBJECTIVE: To describe the needs of physicians for continuing education in geriatrics as perceived by patients and community informants. DESIGN: Cross-sectional survey by mail and in-person interviews. SETTING: Organizations working with the elderly in the community and patients in a primary care population in Calgary. PARTICIPANTS: Key informants working with the elderly in the community, including managers and providers of physical, psychosocial, educational, or mental health services to the elderly, and the first two geriatric patients visiting physicians after telephone contact from study investigators were surveyed. Twenty-five of 27 key community informants and 32 of 61 geriatric patients responded. MAIN OUTCOME MEASURE: Potential topics for continuing medical education. RESULTS: The 10 most frequently identified topics were communication, time management, attitudes to the elderly, medication, continuity of care, mental health, medical management of complicated cases, knowledge of community resources, health promotion, and compassion. Patients were more concerned than key informants about the process of care. Key informants were concerned about the technical aspects of care. CONCLUSIONS: The process of care as well as technical aspects of care must be addressed in continuing education in geriatrics for physicians. PMID:8616284

  8. Transforming Social Work Education: The First Decade of the Hartford Geriatric Social Work Initiative

    ERIC Educational Resources Information Center

    Hooyman, Nancy R.

    2009-01-01

    This book, celebrating the Geriatric Social Work Initiative's 10th Anniversary, documents the effect that its educational programs have had on shaping gerontological social work education as a whole. Each chapter highlights various aspects of this John A. Hartford Foundation-funded initiative--its competency-based education, model for curricular…

  9. Hazards of Hospitalization: Hospitalists and Geriatricians Educating Medical Students about Delirium and Falls in Geriatric Inpatients

    ERIC Educational Resources Information Center

    Lang, Valerie J.; Clark, Nancy S.; Medina-Walpole, Annette; McCann, Robert

    2008-01-01

    Geriatric patients are at increased risk for complications from delirium or falls during hospitalization. Medical education, however, generally places little emphasis on the hazards of hospitalization for older inpatients. Geriatricians conducted a faculty development workshop for hospitalists about the hazards of hospitalization for geriatric…

  10. Exploring Strategies to Advance Public-Sector Funding in Geriatric Social Work Education

    ERIC Educational Resources Information Center

    Behrman, Gary; Mancini, Michael; Briar-Lawson, Katharine; Rizzo, Victoria M.; Baskind, Frank; Valentine, Carl

    2006-01-01

    Changing U.S. demographics and family composition are challenging social work education programs to reposition and reconsider how to prepare students for practice in the field of geriatrics. Implications for future social service and health care needs include ongoing training and education of students with competencies in serving geriatric…

  11. EFFECTS OF CHLORDIMEFORM ON CARDIOVASCULAR FUNCTIONAL PARAMETERS. PART 1. LETHALITY AND ARRHYTHMOGENICITY IN THE GERIATRIC RAT

    EPA Science Inventory

    Chlordimeform (CDM), a formamidine pesticide, had a profound effect on the cardiovascular function of geriatric rats. Two-year-old pentobarbital-anesthetized Sprague-Dawley rats (n=8) received sequential intravenous CDM injections of 5, 10, 30, and 60 mg/kg. A control group of ra...

  12. A network-based geriatric rehabilitation programme: study design and baseline characteristics of the patients.

    PubMed

    Hinkka, Katariina; Karppi, Sirkka-Liisa; Aaltonen, Tuula; Ollonqvist, Kirsi; Grönlund, Rainer; Salmelainen, Ulla; Puukka, Pauli; Tilvis, Reijo

    2006-06-01

    The objective of this paper is to present the design and participants of an ongoing randomized controlled trial on a network-based geriatric rehabilitation programme, targeted at frail elderly persons with progressively declining health and a high risk of institutionalization. Forty-one municipalities, seven rehabilitation centres and a total of 741 frail elderly (65+years) community-living persons participated in the study. Assessments included measurements of physical capacity (balance, handgrip strength, walking speed), Functional Independence Measure, Geriatric Depression Scale, 15 Dimension quality of life questionnaire and Mini Mental State Examination. Questionnaires covered physical, social and psychological factors. The participants were old (mean age 78 years, range 65-96) and mainly female (86%). They were physically frail and most of them (66%) had experienced deterioration of health within 1 year. The majority lived alone (72%) and received regular help from other people (99%). The mean Mini Mental State Examination and Geriatric Depression Scale scores were 25.2 and 4.1 points, respectively. Depressive mood (Geriatric Depression Scale>6 points) was found in 17% and declined cognitive function (Mini Mental State Examination<24 points) in 28% of the participants. Differences between the randomized intervention and control groups were insignificant. Since the number of participants is sufficient statistically, the prospects for evaluating the effectiveness of the programme, and identifying potential benefactors, are good. PMID:16609319

  13. Distance Learning: Videoconferences as Vehicles for Faculty Development in Gerontology/Geriatrics.

    ERIC Educational Resources Information Center

    Wood, Joan B.; Parham, Iris A.

    1996-01-01

    From 1985-1992 the Virginia Geriatric Education Center broadcast via satellite 22 videoconferences involving over 22,000 health professionals in the United States, Canada, and Bermuda. The program required substantial marketing to attract sufficiently large audiences to be cost effective, was labor intensive, and necessitated technical expertise.…

  14. Geriatric Education across 94 Million Acres: Adapting Conference Programming in a Rural State

    ERIC Educational Resources Information Center

    Murphy-Southwick, Colleen; McBride, Melen

    2006-01-01

    Montana, a predominantly rural state, with a unique blend of geography and history, low population density, and cultural diversity represents the challenges for program development and implementation across remote areas. The paper discusses two statewide multidisciplinary geriatric education programs for health professionals offered by the…

  15. Aging Q3: an initiative to improve internal medicine residents' geriatrics knowledge, skills, and clinical performance.

    PubMed

    Moran, William P; Zapka, Jane; Iverson, Patty J; Zhao, Yumin; Wiley, M Kathleen; Pride, Pamela; Davis, Kimberly S

    2012-05-01

    A growing number of older adults coupled with a limited number of physicians trained in geriatrics presents a major challenge to ensuring quality medical care for this population. Innovations to incorporate geriatrics education into internal medicine residency programs are needed. To meet this need, in 2009, faculty at the Medical University of South Carolina developed Aging Q(3)-Quality Education, Quality Care, and Quality of Life. This multicomponent initiative recognizes the need for improved geriatrics educational tools and faculty development as well as systems changes to improve the knowledge and clinical performance of residents. To achieve these goals, faculty employ multiple intervention strategies, including lectures, rounds, academic detailing, visual cues, and electronic medical record prompts and decision support. The authors present examples from specific projects, based on care areas including vision screening, fall prevention, and caring for patients with dementia, all of which are based on the Assessing Care of Vulnerable Elders quality indicators. The authors describe the principles driving the design, implementation, and evaluation of the Aging Q(3) program. They present data from multiple sources that illustrate the effectiveness of the interventions to meet the knowledge, skill level, and behavior goals. The authors also address major challenges, including the maintenance of the teaching and modeling interventions over time within the context of demanding primary care and inpatient settings. This organized, evidence-based approach to quality improvement in resident education, as well as faculty leadership development, holds promise for successfully incorporating geriatrics education into internal medicine residencies. PMID:22450181

  16. The Sensitivity of the Geriatric Oral Health Assessment Index to Dental Care.

    ERIC Educational Resources Information Center

    Dolan, Teresa A.

    1997-01-01

    A 24-month study of 96 patients in a community-based oral health promotion project found the Geriatric Oral Health Assessment Index (GOHAI), a self-report measure of oral health, to be sensitive to provision of dental care. Some further development of measures is needed. Potential applications of this and similar self-report measures in dental…

  17. Geriatric Continuing Education in the Workplace: Utilizing Interactive Television (ITV) Technology in Theory and Practice.

    ERIC Educational Resources Information Center

    Johnson, Helen Arleen; Roman, Marian

    2003-01-01

    Describes the design of two 40-hour geriatrics education programs based on Moore's Theory of Transactional Distance and delivered via interactive televison to mental health/mental retardation professionals. Discusses budgeting, technical support, and training issues involved. (Contains 28 references.) (SK)

  18. Gender Bias in the Diagnosis of a Geriatric Standardized Patient: A Potential Confounding Variable

    ERIC Educational Resources Information Center

    Lewis, Roya; Lamdan, Ruth M.; Wald, David; Curtis, Michael

    2006-01-01

    Background: Gender bias has been reported in the diagnosis and treatment of patients with a variety of illnesses. In the context of our 10-station fourth year Objective Structured Clinical Evaluation, we queried whether this could influence diagnosis in a geriatric case. Case writers hypothesized that, due to this bias, the female standardized…

  19. Quality Assurance in Gerontological and Geriatric Training Programs: The European Case

    ERIC Educational Resources Information Center

    Politynska, Barbara; van Rijsselt, Rene J. T.; Lewko, Jolanta; Philp, Ian; Figueiredo, Daniella; De Sousa, Lilliana

    2012-01-01

    Quality assurance (QA) in gerontological and geriatric education programs is regarded as essential to maintain standards, strengthen accountability, improve readability of qualifications, and facilitate professional mobility. In this article the authors present a summary of international developments in QA and elaborate four international trends,…

  20. Proximal mandibular nerve block, using electrolocation, for rostral mandibulectomy in a geriatric dog

    PubMed Central

    Carotenuto, Alessandra M.; Ravasio, Giuliano; Fonda, Diego; Stefanello, Damiano

    2011-01-01

    We describe a case of proximal mandibular nerve block with ropivacaine, using electrolocation, for perioperative pain management in a geriatric dog undergoing rostral mandibulectomy. The patient did not require intraoperative analgesia or analgesic supplementation for 8 h after the end of the surgery. PMID:22043072

  1. Determinants of Length of Stay in Stroke Patients: A Geriatric Rehabilitation Unit Experience

    ERIC Educational Resources Information Center

    Atalay, Ayce; Turhan, Nur

    2009-01-01

    The objective was to identify the predictors of length of stay--the impact of age, comorbidity, and stroke subtype--on the outcome of geriatric stroke patients. One hundred and seventy stroke patients (129 first-ever ischemic, 25 hemorrhagic, and 16 ischemic second strokes) were included in the study. The Oxfordshire Community Stroke Project…

  2. Medical Student and Senior Participants' Perceptions of a Mentoring Program Designed to Enhance Geriatric Medical Education

    ERIC Educational Resources Information Center

    Corwin, Sara J.; Frahm, Kathryn; Ochs, Leslie A.; Rheaume, Carol E.; Roberts, Ellen; Eleazer, G. Paul

    2006-01-01

    In 2000, the Senior Mentor Program was implemented as an innovative, instructional method in the University of South Carolina's medical school curriculum designed to enhance and strengthen student training in geriatrics. This study qualitatively analyzed second-year medical students' and senior participants' perceptions of and attitudes towards…

  3. 76 FR 54536 - Geriatrics and Gerontology Advisory Committee; Notice of Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-09-01

    ... VHA efforts regarding dementia and program advances in palliative care, and performance and oversight... gerontology. The Committee assesses the capability of VA health care facilities and programs to meet the... on VA's geriatrics and extended care programs, aging research activities, update on VA's...

  4. BRIEF REPORT: Brief Instrument to Assess Geriatrics Knowledge of Surgical and Medical Subspecialty House Officers

    PubMed Central

    Williams, Brent C; Fitzgerald, James T

    2006-01-01

    PROBLEM Initiatives are underway to increase geriatrics training in nonprimary care disciplines. However, no validated instrument exists to measure geriatrics knowledge of house officers in surgical specialties and medical subspecialties. METHODS A 23-item multiple-choice test emphasizing inpatient care and common geriatric syndromes was developed through expert panels and pilot testing, and administered to 305 residents and fellows at 4 institutions in surgical disciplines (25% of respondents), emergency medicine (29%), medicine subspecialties (19%), internal medicine (12%), and other disciplines (15%). RESULTS Three items decreased internal reliability. The remaining 20 items covered 17 topic areas. Residents averaged 62% correct on the test. Internal consistency was appropriate (Cronbach's α coefficient = 0.60). Validity was supported by the use of expert panels to develop content, and by overall differences in scores by level of training (P<.0001) and graded improvement in test performance, with 58%, 63%, 62%, and 69% correct responses among HO1, HO2, HO3, and HO4s, respectively. CONCLUSIONS This reliable, valid measure of clinical geriatrics knowledge can be used by a wide variety of surgical and medical graduate medical education programs to guide curriculum reform or evaluate program performance to meet certification requirements. The instrument is now available on the web. PMID:16704394

  5. The Geriatric Hand: Correlation of Hand-Muscle Function and Activity Restriction in Elderly

    ERIC Educational Resources Information Center

    Incel, Nurgul Arinci; Sezgin, Melek; As, Ismet; Cimen, Ozlem Bolgen; Sahin, Gunsah

    2009-01-01

    On the basis of the importance of hand manipulation in activities of daily living (ADL), deterioration of hand function because of various factors reduces quality and independence of life of the geriatric population. The aim of this study was to identify age-induced changes in manual function and to quantify the correlations between hand-muscle…

  6. Geriatrics Education in Psychiatric Residencies: A National Survey of Program Directors

    ERIC Educational Resources Information Center

    Warshaw, Gregg A.; Bragg, Elizabeth J.; Layde, Joseph B.; Meganathan, Karthikeyan; Brewer, David E.

    2010-01-01

    Objective: The authors describe the current characteristics of geriatrics training within general psychiatry training programs. Methods: In the fall of 2006, a survey was mailed and made available online to all U.S. psychiatric residency program directors (N=181). Results: The response rate was 54% (n=97). Of the responding psychiatry programs,…

  7. The Geriatric Functional Score Scale: A Preliminary Report on a Useful Tool for Assessing the Elderly.

    ERIC Educational Resources Information Center

    Lowe, Shari; Durrell, Kelly

    1988-01-01

    The Geriatric Function Score Scale was developed for the elderly. It is an objective tool that examines physical, cognitive, and motivational components of functioning. Results of a preliminary study revealed that the score patients received was able to discriminate the level of placement they would need upon hospital discharge. (Author/CH)

  8. Development of a Comprehensive Approach for the Early Diagnosis of Geriatric Syndromes in General Practice

    PubMed Central

    Senn, Nicolas; Monod, Stéfanie

    2015-01-01

    According to demographic projections, a significant increase in the proportion of the elderly population is anticipated worldwide. This aging of the population will lead to an increase in the prevalence of chronic diseases and functional impairment. This expected increase will result in growing use of the health care system that societies are largely unprepared to address. General practitioners (GPs) are at the front line of this huge epidemiological challenge, but appropriate tools to diagnose and manage elderly patients in routine general practice are lacking. Indeed, while primary prevention and the management of common chronic diseases, such as hypertension, diabetes, or cardiac ischemic diseases, are routinely and mostly adequately performed in primary care, the management of geriatric syndromes is often incomplete. In order to address these shortcomings, this theoretical work aims to first develop, based on the best available evidence, a brief assessment tool (BAT) specifically designed for geriatric syndromes identification in general practice and, second, to propose a conceptual framework for the management of elderly patients in general practice that integrates the BAT instrument into the usual care of GPs. To avoid proposing unachievable goals for the care of elderly patients in general practice (for example, performing all the best screening tools for geriatric conditions identification and care), this work proposes an innovative way to combine geriatric assessment with the management of common chronic diseases. PMID:26636085

  9. RAND/Hartford initiative to build interdisciplinary geriatric health care research centers.

    PubMed

    Pincus, Harold Alan; Keyser, Donna J; Schultz, Dana J

    2007-01-01

    A RAND/John A. Hartford Foundation initiative, Building Interdisciplinary Geriatric Health Care Research Centers, seeks to promote such research through developing innovative clinical and health services interventions. Interdisciplinary education, mentoring, and training opportunities, particularly for junior investigators, are the critical components necessary to foster multiprofessional research endeavors. PMID:17211038

  10. The Impact of Curricular Changes on the Geriatrics Knowledge, Attitudes and Skills of Medical Students

    ERIC Educational Resources Information Center

    Nagoshi, Michael H.; Tanabe, Marianne K. G.; Sakai, Damon H.; Masaki, Kamal H.; Kasuya, Richard T.; Blanchette, Patricia L.

    2008-01-01

    We redesigned our medical school's Problem-Based Learning (PBL) curriculum to include a substantial increase in required geriatrics content. Innovations included new PBL health care problems and standardized patients (SPs) throughout the first three years and a new required four-week, fourth-year rotation. We used data from the AAMC Medical School…

  11. A Brief Version of the Geriatric Depression Scale for the Chinese

    ERIC Educational Resources Information Center

    Cheng, Sheung-Tak; Chan, Alfred C. M.

    2004-01-01

    Elderly persons (N=310) attending outpatient psychiatric clinics were given an interview on the 30-item Geriatric Depression Scale (T. L. Brink et al., 1982; J. A. Yesavage et al., 1983) and received an independent psychiatric evaluation. A 3-step binary logistic regression showed that 2 items measuring positive affect and 2 others measuring…

  12. Fellows' Perceptions of a Mandatory Reflective Electronic Portfolio in a Geriatric Medicine Fellowship Program

    ERIC Educational Resources Information Center

    Ruiz, Jorge G.; Qadri, Syeda S.; Karides, Marina; Castillo, Carmen; Milanez, Marcos; Roos, Bernard A.

    2009-01-01

    Electronic portfolios (ePortfolios) can be useful for evaluating and documenting mastery of competencies. We investigated geriatric medicine fellows' perceptions of an ePortfolio. We conducted surveys and focus groups followed by quantitative and qualitative data analysis. Our study revealed that fellows considered the ePortfolio acceptable and…

  13. Validation of Geriatric Depression Scale--5 Scores among Sedentary Older Adults

    ERIC Educational Resources Information Center

    Marquez, David X.; McAuley, Edward; Motl, Robert W.; Elavsky, Steriani; Konopack, James F.; Jerome, Gerald J.; Kramer, Arthur F.

    2006-01-01

    This study examined the validity of Geriatric Depression Scale--5 (GDS-5) scores among older sedentary adults based on its structural properties and relationship with external criteria. Participants from two samples (Ns = 185 and 93; M ages = 66 and 67 years) completed baseline assessments as part of randomized controlled exercise trials.…

  14. The Prevalence of Undiagnosed Geriatric Health Conditions among Adult Protective Service Clients

    ERIC Educational Resources Information Center

    Heath, John M.; Brown, Merle; Kobylarz, Fred A.; Castano, Susan

    2005-01-01

    Purpose: We sought to determine the prevalence of remediable health conditions from in-home geriatric assessments of referred adult protective service (APS) clients suffering elder mistreatment. Design and Methods: We used a retrospective cohort study of 211 APS clients (74% female; age, M = 77 years) in two central New Jersey counties. Results:…

  15. Integrated Clinical Geriatric Pharmacy Clerkship in Long Term, Acute and Ambulatory Care.

    ERIC Educational Resources Information Center

    Polo, Isabel; And Others

    1994-01-01

    A clinical geriatric pharmacy clerkship containing three separate practice areas (long-term, acute, and ambulatory care) is described. The program follows the medical education clerkship protocol, with a clinical pharmacy specialist, pharmacy practice resident, and student. Participation in medical rounds, interdisciplinary conferences, and…

  16. Cognitive-Behavioral and Psychodynamic Group Psychotherapy in Treatment of Geriatric Depression.

    ERIC Educational Resources Information Center

    Steuer, Joanne L.; And Others

    1984-01-01

    Assessed whether depressed geriatric patients (N=33) would respond to group psychotherapy and, if they would respond differently to cognitive-behavioral and psychodynamic modes. Results indicated that patients showed statistically and clinically significant reductions on observer-rated measures of depression and anxiety, as well as on self-report…

  17. The Institutionalized Geriatric Patient Considered in a Framework of Developmental Deprivation.

    ERIC Educational Resources Information Center

    Erber, Joan T.

    1979-01-01

    An overview is presented of several areas of deprivation research (animal, child, young adult) and methods of conceptualizing and measuring deprivation is applied to institutionalized geriatric patients. Suggestions are made for more precise approaches to studying and treating deprivation in this population. (Author/SS)

  18. Team Assessment of Geriatric Mental Patients: The Care of Functional Dementia Produced by Hysterical Behavior.

    ERIC Educational Resources Information Center

    Kirby, Henry B.; Harper, Robert G.

    1987-01-01

    Multidisciplinary team identified hysterical behavior, rather than depression, as one form of pseudodementia in many cases of cognitive impairment observed in geriatric patients. Seven cases required thorough medical and neuropsychological assessment and careful functional analysis of patients' behavior patterns to determine the adaptive utility…

  19. Humanistic Health Care Components in a Course on the Geriatric Patient: A Rationale and a Strategy.

    ERIC Educational Resources Information Center

    Sumner, Edward D.; Kaylor, C. Edward, Jr.

    1982-01-01

    Components of instruction and exercises in humanistic health care added to an interdisciplinary pharmacy course on the geriatric patient are described. Included in the coursework are values and attitudes concerning elderly people, interpersonal communication skills, and special psychological and social complexities of old age. (MSE)

  20. [Challenges in geriatric rehabilitation: the development of an integrated care pathway].

    PubMed

    Everink, Irma Helga Johanna; van Haastregt, Jolanda C M; Kempen, Gertrudis I J M; Dielis, Leen M J; Maessen, José M C; Schols, Jos M G A

    2015-04-01

    Coordination and continuity of care within geriatric rehabilitation is challenging. To tackle these challenges, an integrated care pathway within geriatric rehabilitation care (hospital, geriatric rehabilitation and follow-up care in the home situation) has been developed. The aim of this article is to expound the process of developing the integrated care pathway, and to describe and discuss the results of this process (which is the integrated care pathway). Developing the integrated care pathway was done by the guidance of the first four steps of the theoretical framework for implementation of change from Grol and Wensing: (1) development of a specific proposal for change in practice; (2) analysis of current care practice; (3) analysis of the target group and setting; and (4) development and selection of interventions/strategies for change. The organizations involved in geriatric rehabilitation argued that the integrated care pathway should focus on improving the process of care, including transfer of patients, handovers and communication between care organizations. Current practice, barriers and incentives for change were analyzed through literature research, expert consultation, and interviews with the involved caregivers and by establishing working groups of health care professionals, patients and informal caregivers. This resulted in valuable proposals for improvement of the care process, which were gathered and combined in the integrated care pathway. The integrated care pathway entails agreements on (a) the triage process in the hospital; (b) active engagement of patients and informal caregivers in the care process; (c) timely and high quality handovers; and (d) improved communication between caregivers. PMID:25838179