Gerontology & geriatric medicine
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Gerontol Geriatr Med · Jan 2020
"We Are Here to Assist All Individuals Who Need Hospice Services": Hospices' Perspectives on Improving Access and Inclusion for Racial/Ethnic Minorities.
Background: Racial/ethnic minority populations in the United States are less likely to utilize hospice services nearing their end of life, potentially diminishing their quality of care while also increasing medical costs. Objective: Explore the minority hospice utilization gap from the hospice perspective by examining perceived barriers and facilitators as well as practices and policies. Method: Qualitative surveys were conducted with 41 hospices across the United States. ⋯ Another major theme was the importance of community outreach activities that extended beyond the medical community and forming relationships with churches, racial/ethnic minority community leaders, and Native American reservations. Conclusion: The importance of incorporating a culture of inclusivity by forming committees, providing language services, and offering culturally competent care emerged in this qualitative study. Building strong external relationships with community groups such as churches is a strategy used to increase racial/ethnic minority utilization of hospice.
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Gerontol Geriatr Med · Jan 2020
Detecting Prefrailty: Comparing Subjective Frailty Assessment and the Paulson-Lichtenberg Frailty Index.
We examined the level of agreement between subjective frailty assessments (SFA) and frailty classifications derived from the validated Paulson-Lichtenberg Frailty Index (PLFI). Clinic patients (n = 202) were classified as healthy, prefrail, or frail first by screening using the PLFI and later by two geriatric nurses and two geriatricians according to SFA. Of the 202 participants (mean age = 76.7 ± 8.6), 52 (26%) were prefrail and 57 (28%) were frail based on the PLFI. ⋯ Nurse SFA aligned with the PLFI in 43.9% of prefrail and 17.0% of frail cases. There was slight-to-fair agreement between SFA and PLFI (geriatrician: Cohen's κ = .23; 95% confidence interval (CI) = [.11, .35], p < .001; nurse: Cohen's κ = .20; 95% CI = [.08, .33], p = .001). Clinician SFA did not align well with PLFI classifications.
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Gerontol Geriatr Med · Jan 2020
The Association Between Health Status and Insomnia, Mental Health, and Preventive Behaviors: The Mediating Role of Fear of COVID-19.
This study examined the mediation role of fear of COVID-19 in the association between perceived health status of older adults and their insomnia, mental health, and COVID-19 preventive behaviors so as to have better understanding of the factors associated with COVID-19 and its preventive measures. ⋯ Fear of COVID-19 has an important role to play in the management of the health and preventive behaviors of older adults. Health experts and communicators may capitalize on these findings to educate people on COVID-19. Future studies are needed to perfectly ascertain the extent of fear needed to stimulate or initiate better preventive behaviors and healthcare practices.