Zeitschrift für Gerontologie und Geriatrie
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Pain is a widespread symptom in clinical practice. Older adults and chronically ill patients are particularly affected. In multimorbid geriatric patients, pharmacological pain treatment is an extension of a previously existing multimedication. ⋯ The risk of potential drug interactions seems to be low. Apart from the risk of sedation in combination with other drugs, tramadol and other opioids can induce the serotonin syndrome. Among older adults, especially in the case of polypharmacy, an individualized approach should be considered instead of sticking to the pain management recommended by the World Health Organization (WHO) in order to minimize drug-drug interactions and adverse drug reactions.
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Review
[Informal non-kin support for elderly people living alone and end of life care. Literature review].
Older people living alone are a disadvantaged group of society with regard to preferences for care, especially in the last phases of life. Non-kin carers seem to play a vital role for these people; however, these carers tend to be neglected in research as well as policy compared to professional caregivers or family members. ⋯ Non-kin carers face several challenges and have to deal with increasing needs for physical care towards the end of life. Palliative care services are most often involved at this phase. More research is needed to better understand the limits as well as ressources of non-kin carers and the interplay between them and professional carers.
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Time of surgery, age, sex, and co-morbidities influence the complication and mortality rate in patients with hip fractures. Patients with relevant co-morbidities, who were hospitalized at the weekend have a higher mortality rate. Complications prolong length of stay (LOS), which results in higher costs and shortage of bed capacity. ⋯ Hospitalization is influenced by age, ASA and co-morbidities as well as by time to surgery and operation in day or late and nighttime service. Early surgery and prevention of surgical complications reduce LOS.
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Given the demographic changes, the need for effective geriatric intervention is obvious. Geriatric care aims to maintain the highest possible level of independence and quality of life and to reduce the risk of need for care. ⋯ Geriatric patients seem to experience long-term improvements during geriatric treatment, which appears to fulfill its aim of recovering independence. For a better understanding of relevant factors for the recreation of geriatric patients, further research is needed, e.g. with respect to the impact of the nutritional status.
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The English version of the de Morton Mobility Index (DEMMI) enables allied health professions in an inpatient setting to assess the mobility of geriatric patients in a reliable, valid, easy and fast way, without showing any floor or ceiling effects. The aim of this study was the DEMMI's cross-cultural adaption into German language with further analysis of some of its psychometric properties based on this process. ⋯ The DEMMI is already applicable in the German-speaking world. However, further research on its validity and reproducibility are desirable.