Journal of the American Geriatrics Society
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The current evidence base regarding the effectiveness of home-based palliative care (HomePal) on outcomes of importance to multiple stakeholders remains limited. The purpose of this study was to compare end-of-life care in decedents who received HomePal with two cohorts that either received hospice only (HO) or did not receive HomePal or hospice (No HomePal-HO). ⋯ Earlier comprehensive palliative care in patients' home in place of or preceding hospice is associated with fewer hospitalizations and SNF stays and more time at home in the final 6 months of life. J Am Geriatr Soc, 2019.
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While women obtain most recommended preventive health interventions more often than men, evidence is mixed regarding influenza vaccination for older adults. Therefore, we evaluated sex differences in influenza vaccination among older adults. ⋯ Women in MA experience small disparities overall in influenza immunization, with larger disparities for black and Hispanic women. Providers and MA plans should increase efforts to recommend and monitor immunization for older women, especially black and Hispanic women and those in poor health. Given the potential to reduce morbidity and mortality, equitable access to a critical preventive health service, such as influenza immunization, is crucial for all older adults.
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In late-stage dementia, families often prioritize quality of life (QoL) and comfort, yet little research examines factors impacting QoL. We sought to (1) describe temporal trends in QoL in late-stage dementia, and (2) explore associations between patient characteristics, care interventions, and QoL. ⋯ Families judge QoL to be moderately good in late-stage dementia. They perceive activities, opportunities to leave the NH, and quality of interpersonal care as ways to improve dementia-specific QoL.
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Dissemination of cutting-edge geriatrics-focused research is essential for academic geriatrics researchers, clinicians, and older adults and their caregivers. Social media channels, such as Twitter, provide a means of quickly reaching a wide array of users, globally. Besides standard tweets with links to research articles, visual abstracts are a means of delivering research results visually to end users succinctly. ⋯ While the standard tweet received 24 984 impressions with 17 retweets and 36 likes over 8 days, the visual abstract inclusive tweet received 168 447 impressions with 81 retweets and 100 likes in 4 days. To assist researchers on future visual abstract development, we provide a framework and real-world guide on translation of research abstracts into visual abstracts. We hope that by providing evidence and the means to create visual abstracts, researchers in geriatrics may be empowered to disseminate their research through this method and potentially advance the care of older adults worldwide.
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Randomized Controlled Trial Multicenter Study Pragmatic Clinical Trial
Pharmacological Management of Delirium in the Intensive Care Unit: A Randomized Pragmatic Clinical Trial.
Delirium in the intensive care units (ICUs) is prevalent, with both delirium duration and delirium severity associated with adverse outcomes. We designed a pragmatic trial to test the efficacy of a pharmacological management of delirium (PMD) bundle in improving delirium/coma-free days and reducing delirium severity among ICU patients. ⋯ Implementing the PMD bundle in the ICU did not reduce delirium duration or severity among critically ill patients.