Journal of the American Geriatrics Society
-
Randomized Controlled Trial Multicenter Study Clinical Trial
Pharmacotherapy of pain in depressed older adults.
To examine pharmacotherapy for pain in a sample of 1,801 depressed older primary care patients. ⋯ Most depressed older adults in the sample reported recent functional impairment from pain and a history of chronic pain, but almost half of those with functional impairment from pain did not report using analgesic medications. Participating organizations varied substantially in their use of analgesics, suggesting that there is room to improve the quality of pain management in depressed older adults.
-
Randomized Controlled Trial Clinical Trial
Effect of person-centered showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial.
To evaluate the efficacy of two nonpharmacological techniques in reducing agitation, aggression, and discomfort in nursing home residents with dementia. The techniques evaluated were person-centered showering and the towel bath (a person-centered, in-bed bag-bath with no-rinse soap). ⋯ Person-centered showering and the towel bath constitute safe, effective methods of reducing agitation, aggression, and discomfort during bathing of persons with dementia.
-
Randomized Controlled Trial Clinical Trial
Operationalizing a frailty index from a standardized comprehensive geriatric assessment.
To construct and validate a frailty index (FI) that is clinically sensible and practical for geriatricians by basing it on a routinely used comprehensive geriatric assessment (CGA) instrument. ⋯ The FI-CGA is a valid, reliable, and sensible clinical measure of frailty that permits risk stratification of future adverse outcomes.
-
To describe hospice enrollment from the perspective of bereaved family members and to identify information about hospice that would encourage patients and families to enroll sooner. ⋯ Many patients and families learn about hospice from someone other than the patient's physician, and most learn about valuable hospice features and services only after enrollment. By providing more information about hospice earlier in the illness course, clinicians may be able to facilitate more-informed and more-timely decisions about hospice enrollment.
-
To determine the national rate and trend of inappropriate medication administration to elderly emergency department (ED) patients. Secondary objectives were to identify risk factors for receiving an inappropriate medication and to determine whether administration is sometimes justified based on diagnosis. ⋯ Elderly ED patients are frequently administered inappropriate medications. Potentially appropriate uses of generally inappropriate drugs cannot account for such administrations. Inappropriate administration rates remain unchanged despite the 1997 publication of explicit criteria.