Zeitschrift für Gerontologie und Geriatrie
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Comparative Study
Palliative care for the geriatric patient in Europe. Survey describing the services, policies, legislation, and associations.
Knowledge about the quality of end-of-life care in the elderly patient in Europe is fragmented. The European Union Geriatric Medicine Society (EUGMS) Geriatric Palliative Medicine (GPM) Interest Group set as one of its goals to better characterize geriatric palliative care in Europe. ⋯ One of the challenges for the years to come will be to develop palliative care structures adapted to the needs of the elderly in Europe, but also to improve the education of health professionals in this field.
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Referral to the intensive care unit (ICU) and frequency of do-not-resuscitate (DNR) decisions at the end of life (EOL) in adult hospitalized patients≥75 years and those<75 years were examined and influencing factors in the elderly were determined. ⋯ Patients≥75 years are less often referred to the ICU at the EOL as compared to patients<75 years old. However, the risk of dying in the ICU was only lower for elderly with cancer and for those admitted to the geriatric ward.
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Case Reports
[Cases from the area between geriatrics and trauma surgery. Examples from the medical arbitration board].
Medical arbitration boards ("Schlichtungsstellen", expert panels for extrajudicial malpractice claim resolution) try to settle claims of suspected malpractice between patients and their physicians and to avoid court trials. Numerous studies found an increasing incidence of adverse events with rising age. Injuries that occur in the hospital are frequently beyond the specialty of the treating physician. ⋯ Adverse events due to negligence are more frequent among the elderly; the reasons are discussed. They will never be entirely preventable. The data presented in this report may be helpful to recognize fractures in time and to ensure adequate treatment, in order to reduce the number of court claims.
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Comparative Study
[Prospective comparison of assessments to evaluate fall risk in a nursing home population].
Falls represent the main health risk in the over-60 age group. Therefore, evaluation of the individual fall risk and assessment of fall mechanisms are important preventive tools. ⋯ The IBS and the Timed-Up-and-Go Test proved to be the most powerful assessment tools for fall prediction. Furthermore, the IBS is able to provide a purposeful adaption of preventive sensomotoric interventions.
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Due to increasing life expectancy, the number of elderly patients needing surgical care is increasing. Improvements in surgical techniques and anesthetic procedures offer the opportunity of surgical intervention even in frail patients. Delirium on admission to the hospital or in the perioperative setting is a common and often serious complication. ⋯ Co-operation between all professions involved throughout hospitalization of the patient was emphasized. The low incidence of delirium in elderly surgical patients resulting from our efforts indicate that - for this setting in a general hospital - the strategy was effective for the prevention of delirium. Nowadays, geriatric nurses are an essential part of the perioperative team and delirium has lost much of its imminence.