Archives of gerontology and geriatrics
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Arch Gerontol Geriatr · Jan 2014
Multicenter StudyThe frequency of and reasons for acute hospital transfers of older nursing home residents.
The purpose of the study was to examine the frequency of and reason for transfer from nursing homes to the emergency department (ED), whether these transfers led to admission to a hospital ward, and whether the transfer rate differs as a function of type of nursing home provider and to identify the frequency of avoidable hospitalizations as defined by the Swedish Association of Local Authorities and Regions (SALAR). The design was retrospective, descriptive. Data were collected in a Swedish municipality where 30,000 inhabitants are 65 years or older. ⋯ The frequency of avoidable hospitalizations was 16% among the 375 hospitalizations. The proportion of transfers to the ED ranged widely between nursing homes. The reasons for this finding ought to be explored.
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Arch Gerontol Geriatr · Jan 2014
Spiritual background and its association with the medical decision of, DNR at terminal life stages.
In recent years personal and clinical dilemmas relating to terminally ill patient-care medical, decisions have increased significantly. Although understanding the patient's medical, nursing and, social background is important, a comprehensive appraisal essential for treating the "whole patient" is, incomplete without a spirituality assessment. Religious beliefs and practices affect medical and health, care decisions and require recognition as a dynamic in coping with suffering, loss, life, and death. ⋯ The hypothesis was verified. People who are perceived as being religious or as being greatly influenced, by faith/spirituality opposed the recommendation implementing DNR. Obtaining a spiritual background assists the physician to understand the patient or family spirituality, facilitates sensitivity to value frameworks and preferences in making medical and health-related, decisions.
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Arch Gerontol Geriatr · Jan 2014
Self-perceived met and unmet care needs of frail older adults in primary care.
In order to provide adequate care for frail older adults in primary care it is essential to have insight into their care needs. Our aim was to describe the met and unmet care needs as perceived by frail older adults using a multi-dimensional needs assessment, and to explore their associations with socio-demographic and health-related characteristics. Cross-sectional baseline data were used from the Frail older Adults: Care in Transition (ACT) study in the Netherlands, consisting of 1137 community dwelling frail older adults aged 65 and above. ⋯ A younger age and a higher educational level were associated with the presence of unmet care needs. In conclusion, most frail older adults in primary care report to receive sufficient help for their physical needs. More attention should be paid to their psychosocial needs.
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Arch Gerontol Geriatr · Nov 2013
Developing and validating a Japanese version of the Assessment of Pain in Elderly People with Communication Impairment.
This study aimed to develop a Japanese version of the Assessment of Pain in Elderly People with Communication Impairment (PACSLAC-J) and evaluate the validity and reliability of the scale for use in older patients with dementia in Japan. All patients from 2 dementia wards at a geriatric hospital and 2 aged care facilities were asked to participate. Demographic data, medical prescriptions, Behavior Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) score, and PACSLAC-J score were obtained from the patients or their medical charts. ⋯ PACSLAC-J total score was not associated with BEHAVE-AD score. Multiple regression analysis showed that total dependence on assistance during transfer (β=0.32, p=0.001), and psychiatric medication prescription (β=0.26, p=0.003) were independently associated with PACSLAC-J score. We found sufficient evidence of the validity and reliability of the PACSLAC-J.
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Arch Gerontol Geriatr · Nov 2013
The ability of three different models of frailty to predict all-cause mortality: results from the European Male Aging Study (EMAS).
Few studies have directly compared the ability of the most commonly used models of frailty to predict mortality among community-dwelling individuals. Here, we used a frailty index (FI), frailty phenotype (FP), and FRAIL scale (FS) to predict mortality in the EMAS. Participants were aged 40-79 years (n=2929) at baseline and 6.6% (n=193) died over a median 4.3 years of follow-up. ⋯ Compared to robust men, those who were FP frail at baseline had a HR for death of 3.84, while those who were FS frail had a HR of 3.87. All three frailty models significantly predicted future mortality among community-dwelling, middle-aged and older European men after adjusting for potential confounders. Our data suggest that the choice of frailty model may not be of paramount importance when predicting future risk of death, enabling flexibility in the approach used.