Relevant bibliographies by topics / Geriatrics – Care

Contents

  1. Journal articles
  2. Dissertations / Theses
  3. Books
  4. Book chapters
  5. Conference papers
  6. Reports

Academic literature on the topic 'Geriatrics – Care'

Author: Grafiati
Published: 4 June 2021
Last updated: 1 February 2022

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Journal articles on the topic "Geriatrics – Care"

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Davis, Paula Bonino. "Reviews and Notes: Geriatrics: Ambulatory Geriatric Care." Annals of Internal Medicine 120, no. 7 (1994): 623. http://dx.doi.org/10.7326/0003-4819-120-7-199404010-00029.

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OO, Moe T., and Dominic D'Costa. "Interface geriatrics: modernising conventional geriatric medical care." Clinical Medicine 12, no. 1 (2012): 99–100. http://dx.doi.org/10.7861/clinmedicine.12-1-99.

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Powers, James. "The Importance of Geriatric Care Models." Geriatrics 4, no. 1 (2018): 5. http://dx.doi.org/10.3390/geriatrics4010005.

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Gnanasekaran, Gowrishankar, and Eduardo Mireles-Cabodevila. "GERIATRICS MICU CO-MANAGEMENT: INTEGRATING GERIATRIC ASSESSMENTS FOR CRITICALLY ILL PATIENTS." Innovation in Aging 3, Supplement_1 (2019): S448. http://dx.doi.org/10.1093/geroni/igz038.1681.

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Abstract Programs like orthogeriatrics, geriatric cardiology have shown to improve outcomes in hospitalized geriatric patients. Our Geriatrics MICU Co-management program is a quality improvement initiative that instigates a partnership approach with critical care medicine in integrating geriatric assessments and build foundation for interdisciplinary care of critically ill patients. MICU (Medical Intensive Care Unit) protocols do not have standard geriatrics assessments integrated in clinical care. An electronic dash-board identifies high risk elderly (HRE) patients admitted at a MICU in a large teaching hospital in Northeast Ohio based on nursing specific screening triggers. A geriatrics co-management team engages in a comprehensive geriatric assessments and care transition. 386 patient were identified using HRE screening triggers in a period of 100 days. 33 % (n=131) were generated as consults for co-management. A pilot review on 131 HRE patients was conducted. 70% (n=93) patients had incident frailty. 93% (n=87) of patients with frailty were diagnosed with incident delirium. 56% (n=74) of patients were newly diagnosed with cognitive impairment. 56 % (N=74) of patients had a medication reduction. An average of 1.23 medication was changed. 85% (n =112) of patients had a warm hand off to the next level of provider on discharge. 90% (n=119) of patients notified improved self-management skills and better understanding of discharge process. The Geri-MICU program demonstrates a patient -centered approach in integrating geriatric assessments for critically ill patients and build foundation of a geriatrics-critical care task force. The program would be a mile stone in optimizing elderly care in critical care units.
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Barrientos, Maureen E., Anna Chodos, Alicia Neumann, Yvonne Troya, and Pei Chen. "IMPACT OF GERIATRIC INTERPROFESSIONAL TRAINING ON ADVANCE CARE PLANNING IN GERIATRIC PRIMARY CARE." Innovation in Aging 3, Supplement_1 (2019): S151—S152. http://dx.doi.org/10.1093/geroni/igz038.544.

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Abstract Currently, an important measure of Advance Care Planning (ACP), Advance Health Care Directives (AHCD) documentation rate, is at 33% for older adults in the United States. To address this disparity, geriatric faculty in an academic geriatric primary care practice aimed to train geriatrics fellows and other interprofessional (IP) learners to engage patients in ACP. As part of a Geriatric Workforce Enhancement Program funded by the Health Resources and Services Administration, geriatrics faculty and the Medical Legal Partnership for Seniors based at University of California Hastings College of Law provided ACP training to fellows and IP learners, including social work interns. In practice, the fellows and social work interns collaborated to incorporate ACP into patient visits and follow-up telephone calls. To monitor ACP progress, research staff reviewed patients’ electronic health records and performed descriptive analysis of the data. In 21 months, 4 geriatrics fellows built a panel of 59 patients who on average had 3 office visits and 7 telephone calls per person. Prior to clinic enrollment, 12 (20.3%) patients had preexisting AHCD, and 47 lacked AHCD documentation. After ACP intervention, 42 of 47 patients without AHCD documentation engaged in ACP discussion. Of those who engaged in ACP discussion, 24 completed AHCD, raising AHCD completion rate to 61%, or 36 patients in the panel of 59. ACP is a complex process that benefits from skilled communication among interprofessional providers and patients. Findings underscore the potential advantages of IP training and engaging patients in ACP discussion in an academic primary care setting.
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Madden, Kenneth, Deviani Maher, Manuel Montero-Odasso, and Robert E. Lam. "Unmet Needs for Geriatric Medicine and Care of the Elderly Physicians Work Force in Canada." Canadian Geriatrics Journal 24, no. 3 (2021): 162–63. http://dx.doi.org/10.5770/cgj.24.555.

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Although the current low workforce availability of care of the elderly (COE) physicians, geriatric medicine specialists, and geriatric psychiatrists is undeniable, the ongoing demographic shift means this situation will only worsen. This evolving crisis is outlined clearly in the article “Updated Inventory and Projected Requirements for Specialist Physicians in Geriatrics” by Basu et al. found in this issue of the Canadian Geriatrics Journal.
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Kalender-Rich, Jessica L., Jonathan D. Mahnken, Lei Dong, Anthony M. Paolo, Deon Cox Hayley, and Sally K. Rigler. "Development of an Ambulatory Geriatrics Knowledge Examination for Internal Medicine Residents." Journal of Graduate Medical Education 5, no. 4 (2013): 678–80. http://dx.doi.org/10.4300/jgme-d-13-00123.1.

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Abstract Background The number of older adults needing primary care exceeds the capacity of trained geriatricians to accommodate them. All physicians should have basic knowledge of optimal outpatient care of older adults to enhance the capacity of the system to serve this patient group. To date, there is no knowledge-assessment tool that focuses specifically on geriatric ambulatory care. Objective We developed an examination to assess internal medicine residents' knowledge of ambulatory geriatrics. Methods A consensus panel developed a 30-question examination based on topics in the American Board of Internal Medicine (ABIM) Certification Examination Blueprint, the ABIM in-training examinations, and the American Geriatrics Society Goals and Objectives. Questions were reviewed, edited, and then administered to medical students, internal medicine residents, primary care providers, and geriatricians. Results Ninety-eight individuals (20 fourth-year medical students, 57 internal medicine residents, 11 primary care faculty members, and 10 geriatrics fellowship-trained physicians) took the examination. Based on psychometric analysis of the results, 5 questions were deleted because of poor discriminatory power. The Cronbach α coefficient of the remaining 25 questions was 0.48; however, assessment of interitem consistency may not be an appropriate measure, given the variety of clinical topics on which questions were based. Scores increased with higher levels of training in geriatrics (P < .001). Conclusion Our preliminary study suggests that the examination we developed is a reasonably valid method to assess knowledge of ambulatory geriatric care and may be useful in assessing residents.
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Lachs, Mark S., and Hirsch S. Ruchlin. "GERIATRICS IN MANAGED CARE: Is Managed Care Good or Bad for Geriatric Medicine?*." Journal of the American Geriatrics Society 45, no. 9 (1997): 1123–27. http://dx.doi.org/10.1111/j.1532-5415.1997.tb05978.x.

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Chow, Stephanie W., Lizette Munoz, Susana Lavayen, Shamsi Fani, Blair MacKenzie, and Audrey Chun. "GERIATRICS PREVENTABLE ADMISSIONS CARE TEAM (GERIPACT): A HIGH-RISK INTENSIVE AMBULATORY GERIATRICS PROGRAM." Innovation in Aging 3, Supplement_1 (2019): S147. http://dx.doi.org/10.1093/geroni/igz038.529.

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Abstract The Geriatrics Preventable Admissions Care Team (GERIPACT) is an inter-professional team of 2 clinicians, 1 social worker, and 1 care coordinator, dedicated to offering temporary intensive ambulatory care services to complex older patients at high-risk for incurring expensive health care (ie. frequent emergency room visits or hospitalizations). GERIPACT services include frequent office visits for medical and social work needs, frequent telephone contact, home visits, specialty visit accompaniment, and a 24/7 telephone hotline. Use of this innovative model aims to serve communities lacking in geriatrician and geriatric social work providers, with a main goal of serving the highest risk older population. We reviewed the healthcare utilization of GERIPACT enrollees 6 months prior-to-enrollment and compared with 6 months following graduation from GERIPACT from 2016 to 2018. 78 patients were evaluated, with 49 total ED visits prior to enrollment and 35 post-graduation, saving 14 ED visits for a ratio of 18 saved ED visits per 100 GERIPACT patients. There were 45 hospitalizations prior to enrollment with 29 hospitalizations post-graduation, saving 16 hospitalizations, or 20 hospitalizations per 100 GERIPACT patients. Hospital days were reduced by 237 days post-graduation. An intensive ambulatory program for high risk geriatrics patients may be shown to be an efficient model of care for targeting those older patients who potentially incur greater expenses to the health care system. This focused team may be deployed to primary care communities with complex elderly patients in need of geriatricians and geriatric social workers, and may reduce unnecessary emergency room visits and inpatient stays.
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Nearing, Kathryn A., Hillary D. Lum, Janna Hardland, Skotti Church, and Stephanie Hartz. "FORMAL TRAINING IN TELEHEALTH UNIQUELY PREPARES AN INTERDISCIPLINARY WORKFORCE IN GERIATRICS AND GERONTOLOGY." Innovation in Aging 3, Supplement_1 (2019): S273—S274. http://dx.doi.org/10.1093/geroni/igz038.1014.

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Abstract Geriatric Research Education and Clinical Centers (GRECCs) are centers of excellence funded by the Veterans Administration for the advancement and integration of research, education and clinical activities in geriatrics and gerontology to improve the health, and health care of, older Veterans. The GRECC Connect program expands access to care for rural-residing older Veterans and caregivers. Eastern Colorado GRECC Connect integrates Associated Health Trainees (Audiology, Psychology, Social Work, Pharmacy) and Geriatric Medicine Fellows into interdisciplinary tele-geriatric and tele-palliative care consultations provided to outlying community-based outpatient clinics. The formal telehealth training includes: (1) an initial didactic orientation to introduce skills, common challenges, and important tips when working with older patients and caregivers via telehealth; (2) direct observation and modeling by preceptors, followed by a structured opportunity to debrief what the trainee observed and address questions; and (3) opportunities to provide Geriatric telehealth services, supported by the interprofessional team and feedback and reflection. A formal competency assessment, standardized observation protocol and debriefing guide support the development and assessment of telehealth competencies. During exit interviews, trainees indicated that these experiences offered unique opportunities to develop their clinical skills, particularly related to active listening and communication. They identified their involvement with GRECC Connect as a highly valued aspect of their Geriatrics training. Rigorous training in telehealth is an essential aspect of workforce development in Geriatrics and Gerontology given the concentration of older adults in rural areas. During this session, we will highlight the value of telehealth training for workforce development in Geriatrics and Gerontology.
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Dissertations / Theses on the topic "Geriatrics – Care"

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Bramstedt, Katrina Andrea 1966. "Formulating a philosophy of just care for the geriatric population amid the opportunities of modern medicine." Monash University, Dept. of Community Medicine and General Practice, 2002. http://arrow.monash.edu.au/hdl/1959.1/8500.

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Goldberg, Sarah. "Confused older patients' experiences of care on a specialist medical and mental health unit compared with standard care wards." Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/13107/.

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There are concerns about cognitively impaired older patients’ experiences of general hospital care. Nottingham University Hospital developed a medical and mental health unit (MMHU) as a demonstration model of best practice dementia care. This thesis describes a controlled clinical trial comparing patients’ experiences of care on the MMHU to standard care wards. Patient experience was measured using the structured non-participant observational tool Dementia Care Mapping. Observations lasted 6 hours during which a score was recorded every five minutes for the patient’s mood and engagement and activity, together with incidents of enhancing and detracting staff behaviours. Noise (alarms, background noise and co-patients calling out) was recorded. 90 (46 MMHU, 44 Standard care) patients were observed between March and December 2011. At admission, most characteristics of patients on MMHU and standard care were similar. However, patients observed on MMHU had more behaviour disturbance, more often were care home residents and were less disabled than those observed on standard care. Patients on MMHU experienced a median 11% (95% Confidence Interval (CI) 2%, 20%) improvement in the proportion of time in positive mood and engagement (79% versus 68%); a median 3 (95%CI 1, 5) more enhancers (4 versus 1); a median 13% (95%CI -17%, -7%) less time noise could be heard (79% versus 92%) but a median 15% (95%CI 1, 23%) increase in proportion of time co-patients called out (21% versus 6%). Patients on MMHU had a better experience of care than those on standard care wards in terms of their mood and engagement, number of enhancers and improved noise levels, but experienced more co-patients calling out. This is the first study measuring an intervention to improve cognitively impaired older patients’ experiences in the general hospital and the first study to use the Dementia Care Mapping tool to evaluate an intervention in this setting.
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Tosangwarn, Suhathai. "Exploring the factors associated with depressive symptoms and understanding stigma associated with living in a care home among older adults residing in care homes in Thailand." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/51098/.

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Background: Thai culture venerates caring for elders, thus care homes are stigmatised as the domain of poor older adults with no family. This impacts negatively on the psychological wellbeing of older residents and the high prevalence of depression reported among them. However, little is understood about the key factors influencing the depressive symptoms and how such stigma is experienced among care home residents. This study explored factors associated with depressive symptoms, internalised stigma, self-esteem, social support and coping strategies among residents from the perspectives of residents and staff. Methods: Mixed methods research (convergent parallel design) was conducted in two care homes in northeast Thailand using a cross-sectional questionnaire, in-depth interview and non-participant observation. A cross-sectional questionnaire study was conducted with 128 older care home residents (with a response rate of 98.46%) using the 15-Item Thai Geriatric Depression Scale, Internalised Stigma of Living in a Care Home Scale, Thai Version of Rosenberg Self-Esteem Scale, Thai Version of Multidimensional Scale of Perceived Social Support and a Coping Strategies Inventory Short Form. Qualitative interviews were conducted with 30 older residents and 20 care home staff purposively sampled from both care homes. Non-participant observation was conducted in various public spaces of the care homes in both care homes for one month. Quantitative data was analysed using the Statistical Package for Social Science (SPSS) IBM PASW Version 22.0 for Windows. Thematic analysis was used to analyse the qualitative data. Results: Depressive symptoms were significantly correlated with internalised stigma, self-esteem and social support (r= 0.563, -0.574, -0.333; p< 0.001), respectively. Perceived internalised stigma of living in a care home was the strongest predictor of care home residents reporting depressive symptoms (odds ratio=9.165). In addition, the qualitative research explained the dynamics of the process of stigma related to three elements: the causes of stigma, the manifestation of stigma and the mitigating factors. Negative beliefs about care homes and people who live in them, coupled with negative attitudes and stereotypes toward older people, are the causes of stigma which are dominated by negative societal attitudes towards care homes. In addition, care home features contributing to stigma and staff issues are negative perceptions and experiences among residents whilst living in care homes. These factors trigger residents exhibiting negative emotions and behaviours (including depressive symptoms). However, the mitigating factors help to diminish or control the manifestation of stigma. These include coping strategies, social support and activities provided in care homes. Conclusion: Older adults who perceived high internalised stigma of LiCH were over nine times as likely to report experiencing depressive symptoms. This was related to the dynamics of the process of stigma with three elements (the causes, the manifestation and the mitigating factors of stigma). The causes of stigma are the factors creating the negative emotions and behaviours among residents living in Thai care homes. In addition, the mitigating factors help to diminish the manifestations of stigma. The most compelling need to improve the physical and mental wellbeing of elderly residents of care homes in Thailand is to combat the societal and cultural stigma associated with this population. This may be achieved through media collaboration, educational interventions in the care home setting and organising social activities for residents and their families.
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Westerfjärd, Ulrika. "Egenvård hos äldre personer." Thesis, Sophiahemmet Högskola, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:shh:diva-1867.

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SAMMANFATTNING Antalet multisjuka äldre ökar på vårdenheterna. Hjälpbehovet är ofta stort då många inkommer undernärda, uttorkade, har konfusion eller inte klarar utföra dagliga aktiviteter självständigt. De multisjuka patienterna har ofta fler åkommor med en eller fler organsvikter och kan kräva akuta insatser. Enligt socialstyrelsen är inte egenvården väldokumenterad i journalsystemen trots det ökade behovet. Antalet äldre multisjuka ökar samtidigt som det allt vanligare förekommer hospitalisering och komplikationer i vårdandet. Studien syftade till att beskriva hur sjuksköterskor uppmuntrade till egenvården för äldre personer. Data inhämtades från strukturerade intervjuer som analyserades utifrån kvalitativ innehållsanalys. I resultatet presenterades fem kategorier och åtta subkategorier som framkom i analysen av intervjuerna. Dessa presenterades enligt följande: klinisk blick, sjuksköterskornas inhämtning av information, hinder för god egenvård, tidsbrist, metoder som ökar individens strategier för god egenvård, organisatoriska ramar, övertro på sig själv och sin förmåga, för liten tro på sig själv och sin förmåga, att möta patientens hinder, integritet, autonomi, förändring i egenvårdsförmåga, teamet som hjälpmedel och resurs. I resultatet framkom det att vård och omvårdnad bör ses som ett komplement till egenvården. Sjuksköterskan har en stor uppgift att observera och undersöka patientens förmåga. Det framkom även att målen behövde vara gemensamma för patient, sjuksköterska, det geriatriska teamet samt verksamheten. Sjukvården behöver anpassa arbetssätt och verksamhetsmål så att de gynnar patientens egenvård. Sjuksköterskorna behöver se betydelsen av individens motivation och förmågor samt använda det geriatriska teamet och de gemensamma målen som resurs.
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Hast, Angelica, and Ann Björkas. "Äldre patienters upplevelser av vården på en geriatrisk vårdavdelning : En intervjustudie." Thesis, Uppsala universitet, Institutionen för folkhälso- och vårdvetenskap, 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-304329.

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Bakgrund: Svensk statistik tyder på att antalet multisjuka äldre kommer att öka. Hälso- och sjukvårdslagen stadgar att vården skall vara av god kvalitet och tillgodose patienternas behov av trygghet. I dagens samhälle föreligger en risk att äldre människor utsätts för ålderism, vilken kan påverka vårdens kvalitet och orsaka ett lidande för de äldre patienterna. Syfte: Att beskriva äldre patienters upplevelser av vården på en geriatrisk vårdavdelning i Mellansverige. Metod: Latent kvalitativ innehållsanalys av tolv semistrukturerade intervjuer. Resultat: Resultatet utgörs av två teman och sju subteman. Temat Upplevelser av att få en god vård beskriver att de äldre patienterna upplevde sig få en vårdande miljö samt att vårdpersonalen fungerade som en hälsoresurs vilket kunde gynna patienternas välbefinnande. Temat belyser att ett gott bemötande och att få bli sedd som en person resulterade i positiva känslor samt att delaktighet och självbestämmande var viktiga faktorer. Temat Upplevelser av att få en bristande vård beskriver att upplevelser av en otrygg omgivning och avsaknad av sjukdomshänsyntagande, bristande bemötande och kunskap samt att inte få en personcentrerad vård resulterade i negativa känslor. Slutsatser: Resultatet visar att det förekommer både positiva och negativa upplevelser av vården på avdelningen. Att de äldre patienterna upplever brister i vården uppmärksammar att det finns en risk för att ålderism existerar och påverkar vårdens kvalitet. Examensarbetet kan tillföra kunskap om och förståelse för hur äldre patienter upplever vården, vilket kan bidra till bättre förutsättningar för en god vårdupplevelse.<br>Background:  Swedish statistics indicate that there will be an increase in the number of elderly with multiple illnesses. The Health Care Act stipulates that the care provided must be of good quality and meet the patients’ needs for security. In today's society there is a risk that older people are subjected to ageism, which can affect the quality of healthcare and expose the older patients to conditions of suffering. Aim: To describe older patients’ experiences of healthcare at a geriatric ward in central Sweden. Methods: A latent qualitative content analysis of twelve semi-structured interviews. Results: The results consist of two themes and seven subthemes. The theme Experiences of getting good health care describes that when older patients experienced a nurturing environment and the caregivers worked as a health resource, it could benefit the patients’ wellbeing. The theme emphasizes that encountering a good reception and being aknowledged as a person resulted in positive emotions, and that participation in the care process and self-determination were key factors. The theme Experiences of receiving a lack of care describes that the experience of an unsafe environment, actual diseases not being taken into account, lack of treatment and knowledge, as well as being denied person-centered care, resulted in negative emotions. Conclusions: The results indicate that both positive and negative resposnses concerning the care at the ward are experienced. The older patients who experience deficiencies in healthcare, recognize that there is a risk that ageism exists, which may affect the quality of care. The thesis provides knowledge and understanding of how older patients experience healthcare which can contribute to better conditions for the patients, in order for them to experience good healthcare.
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Gordon, Adam L. "Does Comprehensive Geriatric Assessment (CGA) have a role in UK care homes?" Thesis, University of Nottingham, 2012. http://eprints.nottingham.ac.uk/12619/.

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UK care home residents are frail, dependent and multimorbid. General practitioners (GPs) provide their healthcare but there is evidence that existing provision fails to meet their needs. Comprehensive Geriatric Assessment (CGA) comprises comprehensive multidisciplinary assessment, goal setting and frequent review. This thesis considers a possible role for CGA in UK care homes through three research projects. The Care Home Literature Review (CHoLiR) was a systematic mapping review of randomized controlled trials (RCTs) in care homes. It found no evidence supporting CGA as a whole but described some CGA components supported by RCTs: advanced care planning; interventions to reduce prescribing; staff education around dementia and end-of-life; calcium/vitamin D and alendronate in preventing fractures and osteoporosis; vaccination/neuraminidase inhibitors in preventing influenza; functional incidental and bladder training for incontinence; and risperidone/olanzapine for agitation. The Care Home Outcome Study (CHOS) was a longitudinal cohort study recording dependency, cognition, behaviour, diagnoses, prescribing, nutrition and healthcare resource use in 227 residents across 11 care homes over six months. It reported high levels of dependency, cognitive impairment, malnutrition, multimorbidity and frequent behavioural disturbance. Polypharmacy and prescribing errors were common. Variability between homes and individuals was significant for most baseline and outcome measures. Staff Interviews in Care Homes (STICH) was a qualitative interview study of 32 staff working with care homes including: GPs; care home managers and nurses; NHS community nurses and specialist practitioners. It described care defined by discontinuity and lack-of-anticipation; driven by communication failure, inadequate training and expertise in frail older patients, and arbitrary boundaries between care homes and the NHS which interfered with care. Using the findings of these studies, the author proposes a model of care which is multidisciplinary, guided by comprehensive assessment, reinforced by frequent review and delivered by experts in the care of frail older patients: CGA has a role in UK care homes.
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Fenech, Maria Aurora. "Physical restraint use within long term care settings for older persons in Malta." Thesis, University of Nottingham, 2016. http://eprints.nottingham.ac.uk/38980/.

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Purpose: To study this locally unexplored scenario and provide a platform of knowledge base and information on physical restraint use, securing relevant information of essence to the older person, care provider and policy makers within care homes. Aims and objectives: This dissertation focuses on care providers’ observations and perceptions concerning (a) the types of restraint devices used in government and privately managed long term care homes for older persons in Malta, (b) their mode and extent of application, (c) older person characteristics which may be conducive to physical restraint use, (d) older persons’ reactions to restraint use (e) care providers’ perceptions to physical restraint use within the context of work, environmental and safety concerns, and (f) how the effects of physical restraint use could influence the older person’s rights, autonomy and integrity. Relevance: The demand for long term care for older persons increases as the population ages. This, coupled with an increasing demand for human resources, aggravates the risk for less humane care for frail and vulnerable older persons. Person centred care is the fulcrum for the quality of service delivery in the care of older persons. It recognises the distinctiveness of each and every person irrespective of mental and functional capabilities, and moves away from the routine-driven, task-oriented and depersonalised services to focus on specific personal needs. Although there is an increasing international body of literature, exploring the concept of physical restraint use in care homes, there is a lack of research-based evidence exploring care providers’ holistic approach to physical restraint use in long term care settings in Malta. More importantly, published papers fail to captivate the human and humane elements of the physically restrained older person. The relevance of physical restraint use is central within care home environments. The knowledge of the framework within which this use operates is necessary for the establishment of a paradigm that places the older person within the hubs of her/his care. Study design: A questionnaire booklet incorporating quantitative and qualitative components was developed, designed and adopted. The questionnaire was anonymous and self-administered by care providers within all Maltese care homes (n=13), managed by the government and private sectors. All care providers within these care homes were eligible for study participation, (medical, allied health, nursing, and nursing support staff). Care providers have direct contact with the older persons, and are therefore in a position to provide first-hand information about the use of physical restraints. Participants were requested to complete and return ‘Physical Restraint Use’ (PRU) questionnaire booklet developed for this study. Four hundred and thirty four questionnaire booklets were distributed and 180 booklets were returned over a 3 month time frame, providing a response rate of 41.5%. Findings: A high observed incidence of physical restraint devices particularly for bed rails and harnesses was registered within both the government and privately managed care homes. Moreover, respondents acknowledged the use of 16 different types of devices, which raised questions as to multiple use of restraining. Privately managed care homes reported a slightly higher incidence of observed devices in use. The observed total duration of restraints in excess of 2 hours by far exceeded durations less than 2 hours in both government and privately managed care homes. Data pertaining to the private care homes points to the existence of potential continual application of restraint. With respect to observations of modalities of physical restraint use (person recommending, explaining, monitoring and deciding, and documentation), within government and privately managed care homes, a consistent statistically higher involvement of management staff in all of the procedures related to the use of restraining was reported. This was however not evident with respect to documenting restraint use within the private sector. Additionally family members/substitute decision makers had a greater influence on recommending restraint use and its removal within privately managed care homes. Nursing support staff offered a greater contribution to monitoring, documenting restraint use in private than in government managed care homes, whilst nurses in government homes contributed more to monitoring restraint use than their professional counterparts within private homes. Care providers’ attitudes on the use of restraining were reported to be the strongest advocators for using physical restraints within care homes, rather than issues related to older persons themselves such as mobility and physical limitations, cognitive problems, continence issues, problems with communication/hearing/vision and activity participation and pharmacological treatment. Respondents also acknowledged observing adverse reactions to restraint use. Care providers reported restlessness to be the most observed reaction from older persons to physical restraint use (87.9%), followed by physical and cognitive consequences (66.7%) and apathy (30.3%). Participants were uncertain that there would be no serious concerns related to work, environment, safety, and caring, should restraints be reduced, scoring between 3.0 and 4.0 on a 5-point Likert scale, with high scores expressing high concerns. Further analysis revealed that both care home sectors tended to favour least restraint use but were reluctant to remove restraint completely. Similarly, private care home respondents disagreed more than government care home respondents with the statement that the majority of physical restraints in use are necessary while nursing and nursing support staff showed a higher agreement with physical restraining being an invasion of a human right than did managers. Training did not impact on the use of restraining within the care homes. . Conclusion: This study highlighted the sensitivity surrounding physical restraint use. It substantiated published data and also offered novel contributions to the body of knowledge pertaining to the physical restraints and their use. Primarily, the study indicated that training had no impact to effecting restraint minimisation approaches within the care homes. Secondly, respondents acknowledged the use of 16 different types of restraining devices. Also, arguments that bed rail use was not considered a restraining device, having become unconditionally and unquestionably the accepted norm within care homes was corroborated through the high reported observed incidence of use. The study also offered a fresh insight into the modalities of physical restraint use, (recommendation to, explaining on, and monitoring/removing restraint device). Few insights into the impact of physical restraining on the human and humane aspects of older person care were captivated in this study, more so as the sensitivity surrounding physical restraining required that the investigation be carried out through care providers’ observations. This situation, within this project, was perhaps the biggest contribution yet, moreover when the study was indicative that care providers’ attitudes towards restraint use were reported to be the strongest advocator for their use. At its most basic level, physical restraining is tantamount to blocking or limiting a person’s free ability to move as she/he pleases, thus infringing on the older person’s human rights. Indeed, physical restraining is the inability of care providers’ to identify and address the needs of the older persons and provide innovative paradigms of care. Restraining implies a failure in people relationships and consequently in the system of care delivery. The message in the bottle must address the urgent provision for personalised services that enable the older person to make full decisions about her/his care through the support of care providers when called for and at later stages through advocates. It is only through these approaches that policies and guidelines could be put in place and managed effectively and efficiently.
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Hooper, Anna. "Great sexpectations : older adults' perceptions about how transitioning to a care home might impact on experiences of sexuality." Thesis, University of Nottingham, 2018. http://eprints.nottingham.ac.uk/49008/.

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Introduction Older adults’ sexuality has been linked with a number of factors associated with wellbeing. Despite sexual practices changing across the lifespan, sexuality remains an important part of the identity of older adults. The ageing population of the United Kingdom is placing increasing demands on care homes, yet despite the recognised benefits of older adults’ sexuality best practice guidelines for care homes either fail to comment on residents’ sexuality or provide recommendations which are too minimal or vague to operationalise. Most research exploring older adults’ sexuality in care homes has focussed on the views of health and social care practitioners who report on their lack of willingness to engage with residents about their sexuality needs. Research which attempts to explore older adults’ sexuality in care homes from the perspective of residents favours quantitative research methods, an approach which arguably fails to acknowledge the changes in sexual expression which occur with age. Furthermore, the lack of consensus regarding the conceptualisation of the term ‘sexuality’ across the literature limits the extent to which research findings can be synthesised. This research sought to contribute to understandings of older adults’ sexuality experiences in care homes from a first-person perspective by adopting a prospective planning approach to explore prognostications about how transitioning to a care home might impact upon experiences of sexuality and participants’ hopes and fears regarding care provision. To increase the interpretability of findings and contextualise responses, the definition of sexuality from the perspective of older adults was also considered. Methods Semi-structured interviews were conducted with ten participants to explore three broad questions: (1) How do older adults define ‘sexuality’? (2) What impact might a care home have on sexuality experience? (3) How would individuals like sexuality to be acknowledged by care services? Face-to-face and telephone interviews were audio recorded, transcribed, and analysed using a hybrid inductive/deductive thematic analysis approach at a mixed manifest/latent level. Results Participants defined sexuality as a multifaceted component of self-identity which held individual meaning and changed across the lifespan. Participants’ definitions of sexuality were compared with the World Health Organisation’s (WHO) working definition of sexuality, and areas of difference and similarity were identified. Participants anticipated that becoming a resident of a care home would prompt significant (and often negative) changes with regards to how they could experience sexuality. Participants wanted services to demonstrate attempts to minimise the environmental impact on sexuality and promote positive experiences in a manner that was responsive to individual need. Discussion While used as an ageless term, ‘sexuality’ has different understandings and applications across the lifespan and remains an important part of the identity of older adults. Findings from this study indicated that participants expected to embody the role of the non-sexual resident when transitioning into a care home, changes in identity which were predicated on living in an environment which was predicted to neither acknowledge nor facilitate positive sexuality experiences.
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Fitch, Christina Johanna. "Telemedicine and elderly care : an investigation into the suitability of an Internet health care system to support blood pressure monitoring for the older person; or telemedicine: one size fits all?" Thesis, University of Portsmouth, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.369473.

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Sinfield, Melissa. "Respectful relationships : an approach to ethical decision-making for gerontic nursing /." View thesis, 2001. http://library.uws.edu.au/adt-NUWS/public/adt-NUWS20030924.140531/index.html.

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Books on the topic "Geriatrics – Care"

1

Malone, Michael L., Elizabeth A. Capezuti, and Robert M. Palmer, eds. Geriatrics Models of Care. Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-16068-9.

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Protocols in primary care geriatrics. 2nd ed. Springer, 1997.

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Protocols in primary care geriatrics. Springer-Verlag, 1991.

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Sloan, John P. Protocols in Primary Care Geriatrics. Springer US, 1991. http://dx.doi.org/10.1007/978-1-4684-0388-6.

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Sloan, John P. Protocols in Primary Care Geriatrics. Springer New York, 1997. http://dx.doi.org/10.1007/978-1-4612-1884-5.

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Nicholl, Claire. Lecture notes: Elderly care medicine. 8th ed. J. Wiley, 2012.

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Stephen, Webster, ed. Lecture notes on geriatrics. 5th ed. Blackwell Science, 1997.

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Dr, Davison William, and Webster Stephen, eds. Lecture notes on geriatrics. 4th ed. Blackwell Scientific Publications, 1993.

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Dr, Davison William, and Webster Stephen, eds. Lecture notes on geriatrics. 3rd ed. Blackwell Scientific Publications, 1988.

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focus, Ferguson's careers in. Careers in focus: Geriatric care. 3rd ed. Ferguson, 2011.

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Book chapters on the topic "Geriatrics – Care"

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Bashan-Gilzenrat, K. Aviva, and Bryan Morse. "Geriatrics." In Surgical Critical Care and Emergency Surgery. John Wiley & Sons, Ltd, 2018. http://dx.doi.org/10.1002/9781119317913.ch47.

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Wasserman, Michael. "Care Coordination." In The Business of Geriatrics. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-28546-7_13.

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Conroy, Simon, Christian Nickel, and Simon P. Mooijaart. "Urgent Care." In Practical Issues in Geriatrics. Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-61997-2_30.

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Sloan, John P. "Palliative Care." In Protocols in Primary Care Geriatrics. Springer New York, 1997. http://dx.doi.org/10.1007/978-1-4612-1884-5_15.

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Kruse, Derek A., and Kristina L. Bailey. "Pulmonary and Critical Care Medicine." In Geriatrics for Specialists. Springer International Publishing, 2016. http://dx.doi.org/10.1007/978-3-319-31831-8_27.

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Kruse, Derek A., and Kristina L. Bailey. "Pulmonary and Critical Care Medicine." In Geriatrics for Specialists. Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-76271-1_25.

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Boult, Chad, and Jennifer L. Wolff. "“Guided Care” for People with Complex Health Care Needs." In Geriatrics Models of Care. Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-16068-9_11.

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Sloan, John P. "Ethical Issues in Geriatrics." In Protocols in Primary Care Geriatrics. Springer US, 1991. http://dx.doi.org/10.1007/978-1-4684-0388-6_18.

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White, Martin G. "Managed Care, Geriatrics, and Nephrology." In Nephrology and Geriatrics Integrated. Springer Netherlands, 2000. http://dx.doi.org/10.1007/978-94-011-4088-1_20.

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Grant, Amanda. "Exotic Animal Geriatrics." In Treatment and Care of the Geriatric Veterinary Patient. John Wiley & Sons, Inc., 2017. http://dx.doi.org/10.1002/9781119187240.ch19.

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Conference papers on the topic "Geriatrics – Care"

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Hsu, Tse-Chuan, Chih-Hung Chang, William C. Chu, Shinn-Ying Ho, Nien-Lin Hsueh, and Wei-Bin Lee. "Applying Cloud Computing Technologies to Gerontology and Geriatrics Health Care System (GGHCS)." In 2013 13th International Conference on Quality Software (QSIC). IEEE, 2013. http://dx.doi.org/10.1109/qsic.2013.33.

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Borgstrom, E., S. Khan, R. Schiff, et al. "13 Practices, issues and possibilities at the interface between geriatrics and palliative care within the hospital: an exploratory study (InGaP)." In Accepted Oral and Poster Abstract Submissions, The Palliative Care Congress 1 Specialty: 3 Settings – home, hospice, hospital 19–20 March 2020 | Telford International Centre. British Medical Journal Publishing Group, 2020. http://dx.doi.org/10.1136/spcare-2020-pcc.13.

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Prasetyoputra, Puguh, and Ari Prasojo. "Disability among the Elderly in Indonesia: An Analysis of Spatial and Socio-demographic Correlates." In 1st International Electronic Conference on Geriatric Care Models. MDPI, 2019. http://dx.doi.org/10.3390/iecgcm-1-06167.

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Thomas, Victoria, Roopa Rao, Cathy Schubert, Andrew Nagel, and Rebecca Kafer. "Cost-Effective Reduction of Acute Care Utilization using Home-Based Heart Failure Program." In 1st International Electronic Conference on Geriatric Care Models. MDPI, 2019. http://dx.doi.org/10.3390/iecgcm-1-06168.

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Teo, Shyh Poh, and Hjh Noridah Hj Abdul Halim. "Multicomponent interventions to prevent and manage pressure injuries in hospital." In 1st International Electronic Conference on Geriatric Care Models. MDPI, 2019. http://dx.doi.org/10.3390/iecgcm-1-06169.

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Nikolaeva, M. A., A. I. Agadullina, and M. I. Dolganov. "Risk Analysis System in Geriatric Care." In Proceedings of the 21st International Workshop on Computer Science and Information Technologies (CSIT 2019). Atlantis Press, 2019. http://dx.doi.org/10.2991/csit-19.2019.35.

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Kuo, Nai-Wen. "A Decision Support System in Geriatric Care." In 2010 Sixth International Conference on Intelligent Information Hiding and Multimedia Signal Processing (IIH-MSP). IEEE, 2010. http://dx.doi.org/10.1109/iihmsp.2010.174.

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Rölker-Denker, Lars, and Andreas Hein. "Abstract Information Model for Geriatric Patient Treatment - Actors and Relations in Daily Geriatric Care." In 10th International Conference on Health Informatics. SCITEPRESS - Science and Technology Publications, 2017. http://dx.doi.org/10.5220/0006106902220229.

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Kumar, E. Sathish, P. Sachin, B. P. Vignesh, and Mohammed Riyaz Ahmed. "Architecture for IOT based geriatric care fall detection and prevention." In 2017 International Conference on Intelligent Computing and Control Systems (ICICCS). IEEE, 2017. http://dx.doi.org/10.1109/iccons.2017.8250636.

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Krveshi, L., R. Vashisht, D. S. Sadana, L. Kokoczka, G. Gnanasekaran, and E. Mireles-Cabodevila. "Outcomes of Triggered Geriatric Consults in Medical Intensive Care Unit." In American Thoracic Society 2020 International Conference, May 15-20, 2020 - Philadelphia, PA. American Thoracic Society, 2020. http://dx.doi.org/10.1164/ajrccm-conference.2020.201.1_meetingabstracts.a7107.

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Reports on the topic "Geriatrics – Care"

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Tipton, Kelley, Brian F. Leas, Nikhil K. Mull, et al. Interventions To Decrease Hospital Length of Stay. Agency for Healthcare Research and Quality (AHRQ), 2021. http://dx.doi.org/10.23970/ahrqepctb40.

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Background. Timely discharge of hospitalized patients can prevent patient harm, improve patient satisfaction and quality of life, and reduce costs. Numerous strategies have been tested to improve the efficiency and safety of patient recovery and discharge, but hospitals continue to face challenges. Purpose. This Technical Brief aimed to identify and synthesize current knowledge and emerging concepts regarding systematic strategies that hospitals and health systems can implement to reduce length of stay (LOS), with emphasis on medically complex or vulnerable patients at high risk for prolonged LOS due to clinical, social, or economic barriers to timely discharge. Methods. We conducted a structured search for published and unpublished studies and conducted interviews with Key Informants representing vulnerable patients, hospitals, health systems, and clinicians. The interviews provided guidance on our research protocol, search strategy, and analysis. Due to the large and diverse evidence base, we limited our evaluation to systematic reviews of interventions to decrease hospital LOS for patients at potentially higher risk for delayed discharge; primary research studies were not included, and searches were restricted to reviews published since 2010. We cataloged the characteristics of relevant interventions and assessed evidence of their effectiveness. Findings. Our searches yielded 4,364 potential studies. After screening, we included 19 systematic reviews reported in 20 articles. The reviews described eight strategies for reducing LOS: discharge planning; geriatric assessment or consultation; medication management; clinical pathways; inter- or multidisciplinary care; case management; hospitalist services; and telehealth. All reviews included adult patients, and two reviews also included children. Interventions were frequently designed for older (often frail) patients or patients with chronic illness. One review included pregnant women at high risk for premature delivery. No reviews focused on factors linking patient vulnerability with social determinants of health. The reviews reported few details about hospital setting, context, or resources associated with the interventions studied. Evidence for effectiveness of interventions was generally not robust and often inconsistent—for example, we identified six reviews of discharge planning; three found no effect on LOS, two found LOS decreased, and one reported an increase. Many reviews also reported patient readmission rates and mortality but with similarly inconsistent results. Conclusions. A broad range of strategies have been employed to reduce LOS, but rigorous systematic reviews have not consistently demonstrated effectiveness within medically complex, high-risk, and vulnerable populations. Health system leaders, researchers, and policymakers must collaborate to address these needs.
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