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Journal articles on the topic 'Older people Medical care'

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Published: 4 June 2021
Last updated: 3 March 2023

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1

Tinker, Anthea, Victoria Berdugo, Michael Buckland, Lois Crabtree, Anistta Maheswaran, Andrea Ong, Jasmine Patel, Emilia Pusey, and Chandini Sureshkumar. "Volunteering with older people in a care home." Working with Older People 21, no. 4 (December 11, 2017): 229–35. http://dx.doi.org/10.1108/wwop-08-2017-0019.

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Purpose The purpose of this paper is to investigate the influence that volunteering before medical school with older people in a care home has on the perceptions of older people. Design/methodology/approach Eight medical students answered an anonymous questionnaire relating to their experiences of volunteering in a care home before medical school. This was combined with an analysis of the relevant literature. Findings All the students had initially volunteered to enhance their CV for medical school. After volunteering, they had a greater realisation of the variety of older people. They also gained a number of transferable skills related to communicating with older people, especially those with cognitive impairment. The greatest learning experience was around the issues to do with dementia. Research limitations/implications The research is based on eight students although they were from different areas. Practical implications It would be beneficial if care homes could be more proactive in encouraging prospective medical students to volunteer. Medical schools could also provide clearer advice or take a more active stance such as encouraging prospective students to volunteer with older people. Further research should be with a larger sample to gain insight into varying perspectives. It would also be useful to conduct research into older adults’ attitudes towards the contribution of potential medical students to their own lives and to the home. Social implications Volunteering before medical school should be encouraged as it will enhance the chances of getting a place as well as being an eye opening experience and equip them with lifelong skills. Originality/value Original.
2

Meyer, Judy, and Maria Oliva. "Beware: The Gaps in Medical Care for Older People." American Journal of Nursing 85, no. 4 (April 1985): 490. http://dx.doi.org/10.2307/3425112.

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&NA;, &NA;. "Beware: The Gaps In Medical Care For Older People." AJN, American Journal of Nursing 85, no. 4 (April 1985): 490. http://dx.doi.org/10.1097/00000446-198504000-00055.

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4

Ryan, Davinia, and Joseph Harbison. "Stroke as a medical emergency in older people." Reviews in Clinical Gerontology 21, no. 1 (October 18, 2010): 45–54. http://dx.doi.org/10.1017/s095925981000033x.

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SummaryIn the last 20 years a realization has developed that acute stroke is a condition that benefits from early intensive investigation and treatment. Older people are historically less likely to receive such active management through a combination of limited evidence due to their exclusion from clinical trials and a level of ‘therapeutic nihilism’ regarding older subjects with severe, acute illness.There is increasing evidence that many acute therapies, including thrombolysis, benefit older stroke patients. Older subjects may not achieve as good results as younger groups but differential benefits are often comparable when expected outcomes are considered. Risk of haemorrhagic complications with thrombolysis is not substantially increased and older subjects are now receiving this therapy despite a dearth of relevant trial data.Intensive physiological monitoring and stroke unit care has been found to be of benefit to patients of all ages. Surgical options for intracerebral haemorrhage are limited, but there is little difference in the management of intracranial haemorrhage in older people. There is unlikely to be a benefit to surgical hemicraniectomy for cerebral infarction in those >60 years. In conclusion, active management for acute stroke in older people is frequently beneficial and age should not be a barrier to such care.
5

Kidana, Kiwami, Shinya Ishii, Itsuki Osawa, Ayu Yoneda, Kiyoshi Yamaguchi, Yumi Yamaguchi, Kanao Tsuji, Masahiro Akishita, and Takashi Yamanaka. "Medication prescription in older people receiving home medical care services." Geriatrics & Gerontology International 19, no. 12 (December 2019): 1292–93. http://dx.doi.org/10.1111/ggi.13793.

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6

Livingston, Gill, Monica Manela, and Cornelius Katona. "Cost of community care for older people." British Journal of Psychiatry 171, no. 1 (July 1997): 56–59. http://dx.doi.org/10.1192/bjp.171.1.56.

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BackgroundThere has been no published study that considers actual costs in a representative sample of people aged ???? 65 years. The present study describes the financial cost of formal community services for elderly people with dementia, depression, anxiety disorders or physical disability.MethodPsychiatric morbidity, physical disability and services received were assessed by standardised questionnaire in randomly selected Islington enumeration districts. Subjects were interviewed at home (.=700).ResultsDementia was the most expensive disorder per sufferer in terms of formal services. Those with depression were also high users of health services. Despite presenting to health services, 90% were not treated with appropriate drugs. In contrast, social services were received by people who were activity-limited or with dementia. The highest service cost for the population as a whole was for the physically disabled. In multivariate analysis the significant predictors of high service costs were living alone, being physically ill, depression, dementia and increasing age.ConclusionsFailure to detect and treat depression and the anxiety disorders in older people, despite their presentation to medical services, may have major economic consequences as well as contributing to individual suffering.
7

Latimer, Joanna. "Socialising Disease: Medical Categories and Inclusion of the Aged." Sociological Review 48, no. 3 (August 2000): 383–407. http://dx.doi.org/10.1111/1467-954x.00222.

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When older peoples' troubles are categorised as social rather than medical, hospital care can be denied them. Drawing on an ethnography of older people admitted as emergencies to an acute medical unit, the article demonstrates how medical categories can provide shelter for older people. By holding their clinical identity on medical rather than social grounds, physicians who specialise in gerontology in the acute medical domain can help prevent the over-socialising of an older person's health troubles. As well as helping the older person to draw certain resources to themselves, such as treatment and care, this inclusion in positive medical categories can provide shelter for the older person, to keep at bay their effacement as ‘social problems'. These findings suggest that contemporary sociological critique of biomedicine may underestimate how medical categorising, as the obligatory passage through which to access important resources and life chances, can constitute a process of social inclusion.
8

Shurgaya, Marina A., S. S. Memetov, and L. V. Silenko. "OLDER GENERATION: MEDICAL AND SOCIAL PROBLEMS." Medical and Social Expert Evaluation and Rehabilitation 20, no. 2 (June 15, 2017): 86–88. http://dx.doi.org/10.18821/1560-9537-2017-20-2-86-88.

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In an article there are presented results of a sociological survey of elderly people who underwent inpatient treatment at the State Budget Institution «Hospital for Veterans of Wars» in the Rostov Region in 2016. The survey was implemented according to a specially developed questionnaire. The respondents included 220 cases of elderly and senile age. The results of the survey showed the majority of elderly respondents, including disabled people, as to mention the main problems of elderly people as health problems and access to medical care as note a high level of anxiety.
9

Sanubari, Theresia Pratiwi Elingsetyo, and Rosiana Evarayanti Saragih. "Berbagi dengan Panti Wreda: Pemeriksaan Kesehatan untuk Menilik Kondisi Kesehatan Lansia." Magistrorum et Scholarium: Jurnal Pengabdian Masyarakat 1, no. 2 (January 29, 2021): 269–77. http://dx.doi.org/10.24246/jms.v1i22020p269-277.

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The shifting of population demography to older people groups encourage Indonesia government create integrative care’s policy. Unfortunately, the nursing home as long term care failed to bring integrative care. This aim of community services is to build integrative care for older people groups in nursing home. The first step to establish integrative care is older people’s mapping regarding their health condition and food management through medical check-up. The activities consist of two steps, which are medical check-up and nutrition education. The result shows older peoples have hypertension, normal blood sugar, mild cognitive condition, and average physical activity. The condition motivate nursing home to organize integrative care with other institutions. In addition, the community services also bring opportunity to regular services, especially to nutrition management and medical check-up.
10

Yang, Wei. "UNDERSTANDING NON-MEDICAL COSTS FOR HEALTH CARE: EVIDENCE FROM INPATIENT CARE FOR OLDER PEOPLE IN CHINA." Innovation in Aging 3, Supplement_1 (November 2019): S733. http://dx.doi.org/10.1093/geroni/igz038.2686.

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Abstract Non-medical costs can constitute a substantial part of total health care costs, especially for older people. Costs associated with carers, travel, food and accommodation for family members accompanying and caring for older people during their medical visits can be hefty. This study seeks to examine the effects of non-medical costs on catastrophic health payments and health payment-induced poverty among older people in rural and urban China. Using data from the China Health and Retirement Longitudinal Survey 2015, this study finds that inpatient costs account for a significant proportion of household expenditure, and non-medical costs can account for approximately 18% of total costs. That share is highest for those who belong to the lowest wealth groups. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. Such effects are more concentrated among the poor than the rich. The results also show that the rural population are more likely to incur catastrophic health payments and suffer from health payment induced poverty compared to the urban population. This paper urges policy makers to consider reimbursing the non-medical costs of patient care, improving health care systems in general and for the rural populations specifically.
11

Morris, Jackie, and Gurcharan S. Rai. "Care of the Elderly: Medical and social care of highly dependent older people." Clinical Risk 9, no. 1 (January 1, 2003): 25–27. http://dx.doi.org/10.1258/135626203762301887.

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12

Ray-Chaudhuri, Arijit, Ryan C. Olley, Rupert S. Austin, and Jennifer E. Gallagher. "The Oral Health Needs of Older People in General Medical Practice: An Overview." InnovAiT: Education and inspiration for general practice 5, no. 10 (January 5, 2012): 614–19. http://dx.doi.org/10.1093/innovait/inr216.

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As the UK population ages and older people retain their natural teeth for longer, the complexity of the oral health needs in older people is becoming more challenging. Older patients are often registered with a GP and will increasingly be likely to require dental care. Older people in particular may benefit from dental care but may not have a dentist or perceive any risk of oral disease. This article therefore provides practical insight into the oral health management of older people to assist in addressing their oral health needs.
13

Wang, Zhenyu, Hanchun Wei, and Zhihan Liu. "Older Adults’ Demand for Community-Based Adult Services (CBAS) Integrated with Medical Care and Its Influencing Factors: A Pilot Qualitative Study in China." International Journal of Environmental Research and Public Health 19, no. 22 (November 11, 2022): 14869. http://dx.doi.org/10.3390/ijerph192214869.

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Introduction: The number of older people in China who require formal care is increasing. In response, China is creating a service delivery mode of health and social care combination for older people—community-based adult services (CBAS) integrated with medical care—in some provincial capital cities, such as Changsha. However, the needs of most older people for this service delivery mode are not well understood. Aim: To assess older people’s awareness of and demand for CBAS integrated with medical care and to determine influencing factors. Methods: Semi-structured guideline interviews were conducted with 20 older people (aged 65+ years) from two communities at different economic development levels and from a nursing home in Changsha, China. Interviews were analyzed using qualitative content analysis. Results: The specific needs that older adults expect from CBAS integrated with medical care involve daily care, primary care, self-management guidance, rehabilitation therapy services, and mental health services. Contrary to expectations, most interviewees showed low awareness of and demand for CBAS integrated with medical care. Individual, family, and community factors influence older people’s demand, as do exogenous variables such as gender and number of children. Discussion: The influencing mechanism of older people’s demand for CBAS integrated with medical care is complex and multifaceted. To implement and promote CBAS integrated with medical care, attention should be given to older people’s individual needs, family backgrounds and community environment improvement. Furthermore, improving awareness of integrated care and increasing ageing-in-place opportunities for more older adults is essential and urgent.
14

Wilson, Mark AG, Susan E. Kurrle, and Ian Wilson. "Understanding Australian medical student attitudes towards older people." Australasian Journal on Ageing 37, no. 2 (January 14, 2018): 93–98. http://dx.doi.org/10.1111/ajag.12495.

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15

Paskulin, Lisiane Manganelli Girardi, Carla Cristiane Becker Kottwitz Bierhals, Daiany Borghetti Valer, Marinês Aires, Nara Veras Guimarães, Anemarie Raymundo Brocker, Laís Haase Lanziotti, and Eliane Pinheiro de Morais. "Health literacy of older people in primary care." Acta Paulista de Enfermagem 25, spe1 (2012): 129–35. http://dx.doi.org/10.1590/s0103-21002012000800020.

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OBJECTIVE: To analyze how elderly people linked to health education groups of a primary care unit seek, understand and share information, aiming to maintain and promote health throughout life. METHODS: Qualitative descriptive study, conducted with 30 elderlies linked to three groups of health education during the second semester of 2009. The data collection was performed through interviews and thematic analysis with the assistance of the NVivo software. RESULTS: Five categories of analysis were elaborated - Interest/concern in health, search, understanding, sharing and impact of information on the elderly. CONCLUSIONS: The health literacy in the groups developed in an individual perspective, focused on the prevention and treatment of injuries, respecting the history and knowledge of the subjects and appreciating the possibilities of exchange among them. The results support the planning, implementation and improvement of actions in health education with older people in primary care.
16

McCabe, Marita P., Tanya Davison, David Mellor, and Kuruvilla George. "Barriers to Care for Depressed Older People: Perceptions of Aged Care among Medical Professionals." International Journal of Aging and Human Development 68, no. 1 (January 2009): 53–64. http://dx.doi.org/10.2190/ag.68.1.c.

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17

Beech, Roger, Bie Nio Ong, Sue Jones, and Vicky Edwards. "Delivering person-centred holistic care for older people." Quality in Ageing and Older Adults 18, no. 2 (June 12, 2017): 157–67. http://dx.doi.org/10.1108/qaoa-05-2016-0019.

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Purpose This paper is an evaluated case study of the Wellbeing Coordinator (WBC) service in Cheshire, UK. WBCs are non-clinical members of the GP surgery or hospital team who offer advice and support to help people with long-term conditions and unmet social needs remain independent at home. The paper aims to discuss this issue. Design/methodology/approach A mixed method design assessed the outcomes of care for recipients and carers using interviews, diaries and validated wellbeing measures. Service utilization data, interviews and observations of WBC consultations enabled investigation of changes in processes of care. Data were analysed using simple descriptive statistics, established instrument scoring systems and accepted social science conventions. Findings The WBC complements medical approaches to supporting people with complex health and social care problems, with support for carers often a key service component. Users reported improvements in their wellbeing, access to social networks, and maintenance of social identity and valued activities. Health and social care professionals recognized the value of the service. Practical implications The WBC concept relieves the burden on health and social care professionals as the social elements of ill-health are addressed. A shift in thinking from ill-health to wellbeing means older people feel more able to regain control over their own lives, being less dependent on consulting professionals. Originality/value The WBC is a new service focussing on the individual in their health, social and economic context. Process and outcomes evaluations are rare in this field.
18

Matthews, Doug. "In-home care and ‘supported independence’ for the frail elderly: A social work perspective." Aotearoa New Zealand Social Work 24, no. 1 (July 8, 2016): 3–13. http://dx.doi.org/10.11157/anzswj-vol24iss1id137.

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The article focuses on role of social workers in providing in-home care and assistance with the activities of daily living (ADL) for older people in New Zealand. From the physician- and hospital-based medical care for older people, a shift back to home-based medical care was emphasized by the Ministry of Social Development in April 2001. The New Zealand Health of Older People Strategy was implemented with the aim of achieving positive aging, quality of life and independence.
19

Harvey, Desley, Michele Foster, Rachel Quigley, and Edward Strivens. "Care transition types across acute, sub-acute and primary care." Journal of Integrated Care 26, no. 3 (July 2, 2018): 189–98. http://dx.doi.org/10.1108/jica-12-2017-0047.

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PurposeThe purpose of the paper is to examine the care transitions of older people who transfer between home, acute and sub-acute care to determine if there were common transition types and areas for improvements.Design/methodology/approachA longitudinal case study design was used to examine care transitions of 19 older people and their carers as a series of transitions and a whole-of-system experience. Case study accounts synthesising semi-structured interviews with function and service use data from medical records were compared.FindingsThree types of care transitions were derived from the analysis: manageable, unstable and disrupted. Each type had distinguishing characteristics and older people could experience elements of all types across the system. Transition types varied according to personal and systemic factors.Originality/valueThis study identifies types of care transition experiences across acute, sub-acute and primary care from the perspective of older people and their carers. Understanding transition types and their features can assist health professionals to better target strategies within and across the system and improve patient experiences as a whole.
20

Travis, Catherine E., and Caren McHenry Martin. "ADA Standards of Medical Care in Diabetes: implications for Older Adults." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 258–65. http://dx.doi.org/10.4140/tcp.n.2020.258.

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Each year, new literature and recommendations are incorporated into updates in the American Diabetes Association's Standards of Medical Care in Diabetes. The 2020 update increased the focus on the rising cost of care for diabetes, long-term outcomes of newer antihyperglycemics in reducing macrovascular and microvascular complications of diabetes, and the importance of individualized treatment goals. These principles are of particular significance when managing older people with diabetes. This article focuses on updates pertinent to care of the older people.
21

Travis, Catherine E., and Caren McHenry Martin. "ADA Standards of Medical Care in Diabetes: implications for Older Adults." Senior Care Pharmacist 35, no. 6 (June 1, 2020): 258–65. http://dx.doi.org/10.4140/tcp.n.2020.258.

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Each year, new literature and recommendations are incorporated into updates in the American Diabetes Association's Standards of Medical Care in Diabetes. The 2020 update increased the focus on the rising cost of care for diabetes, long-term outcomes of newer antihyperglycemics in reducing macrovascular and microvascular complications of diabetes, and the importance of individualized treatment goals. These principles are of particular significance when managing older people with diabetes. This article focuses on updates pertinent to care of the older people.
22

Wagg, A., D. Lowe, P. Peel, and J. Potter. "Continence Care for Older People in England and Wales." Journal of Wound, Ostomy and Continence Nursing 35, no. 2 (March 2008): 215–20. http://dx.doi.org/10.1097/01.won.0000313646.44870.d3.

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Soulis, George, and Marco Inzitari. "Medical care emerging challenges for older people during early COVID-19 pandemic." European Geriatric Medicine 13, no. 2 (February 14, 2022): 505–6. http://dx.doi.org/10.1007/s41999-022-00611-x.

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24

Conroy, Simon, Cassandra Ferguson, James Woodard, and Jay Banerjee. "Interface geriatrics: evidence-based care for frail older people with medical crises." British Journal of Hospital Medicine 71, no. 2 (February 2010): 98–101. http://dx.doi.org/10.12968/hmed.2010.71.2.46488.

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25

BUCHIGNANI, NORMAN, and CHRISTOPHER ARMSTRONG-ESTHER. "Informal care and older Native Canadians." Ageing and Society 19, no. 1 (January 1999): 3–32. http://dx.doi.org/10.1017/s0144686x99007254.

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The number and relative proportion of older Native people in Canada are both increasing rapidly. So also is a social problems discourse asserting that informal care of older Native people by family and kin is traditional, and highly appropriate today. However, neither this discourse nor previous research satisfactorily address the informal care requirements of older Native people nor the gendered implications that high levels of informal care provision may have for Native caregivers. Informal care is provided to Canada's non-Native elderly people primarily by resident wives and non-resident daughters, and secondarily by husbands and sons. Data from the pan-provincial Alberta Native Seniors Study demonstrate that Native people aged 50 or more have comparatively high overall care requirements. Older Native Albertans are poor, and make extensive use of some government income support programmes. They also make moderate use of medical services. Extensive dependence on informal care, institutional barriers and local service unavailability lead Native seniors to under-utilise other formal programmes aimed generically at the older provincial population. Native seniors are much more likely to live with kin than are other Canadians. Informal care appears equally available to older women and men, and is provided chiefly by resident daughters, sons and spouses, and by non-resident daughters, sisters and sons. Extensive elderly caregiving requirements may impose a growing, double burden on many, who are also providing care for dependent children. Without further support, current and future requirements may significantly limit the options of caregiving women and men.
26

Beswick, AD, R. Gooberman-Hill, A. Smith, V. Wylde, and S. Ebrahim. "Maintaining independence in older people." Reviews in Clinical Gerontology 20, no. 2 (April 7, 2010): 128–53. http://dx.doi.org/10.1017/s0959259810000079.

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SummaryAppropriate social and medical interventions may help maintain independence in older people. Determinants of functional decline, disability and reduced independence are recognized and specific interventions target the treatment of clinical conditions, multiple health problems and geriatric conditions, prevention of falls and fractures, and maintenance of physical and cognitive function and social engagement.Preventive strategies to identify and treat diverse unmet needs of older people have been researched extensively. We reviewed systematically recent randomized controlled trials evaluating these ‘complex’ interventions and incorporated the findings of 21 studies into an established meta-analysis that included 108,838 people in 110 trials. There was an overall benefit of complex interventions in helping older people to live at home, explained by reduced nursing home admissions rather than death rates. Hospital admissions and falls were also reduced in intervention groups. Benefits were largely restricted to earlier studies, perhaps reflecting general improvements in health and social care for older people. The wealth of high-quality trial evidence endorses the value of preventive strategies to help maintain independence in older people.
27

Yang, Wei. "Understanding the Non-medical Costs of Healthcare: Evidence from Inpatient Care for Older People in China." China Quarterly 242 (September 16, 2019): 487–507. http://dx.doi.org/10.1017/s0305741019001115.

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AbstractNon-medical costs, including costs associated with carers, travel, food and accommodation for family members who care for older people during their medical visits, can constitute a substantial part of total healthcare costs, especially for older people. Using data from the 2015 China Health and Retirement Longitudinal Survey, this study examines the effects of such non-medical costs on catastrophic health payments and health payment-induced poverty among older people in China. Results indicate that non-medical costs account for approximately 18 per cent of total inpatient costs. The percentage is highest for those in the lowest economic brackets. Rural populations are more likely than urban populations to incur catastrophic health payments and suffer from health payment-induced poverty. Non-medical costs increase the chances of older people incurring catastrophic health payments and suffering from health payment-induced poverty. These findings suggest that policymakers should look to develop new policies that facilitate reimbursement of non-medical costs, particularly for the rural population.
28

Ab Ghani, Nor Nadiya, Aniawanis Makhtar, Sharifah Munirah Syed Elias, Norfadzilah Ahmad, and Salizar Mohamed Ludin. "Knowledge, Practice and Needs of Caregiver in the Care of Older People: A Review." INTERNATIONAL JOURNAL OF CARE SCHOLARS 5, no. 3 (November 30, 2022): 70–78. http://dx.doi.org/10.31436/ijcs.v5i3.269.

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Caregivers play a significant role in the care of older people. However, their knowledge, practice and needs in the care of older people have been poorly characterised. Therefore, this review was performed to provide an overview of caregivers’ knowledge, practice and needs in the care of older people. A literature search was conducted using the following electronic databases: ProQuest Health and Medical Complete, Wiley Online Library, EBSCO Host, Science Direct and Scopus. Search terms used were “older people”, “caregiver”, “knowledge”, “practice” and “needs”. Two reviewers independently screened the studies and the extracted data. A total of 117 articles were initially found using the above keywords. After using a set of criteria in the screening process, nine articles were found relevant to include in this review. This review of the articles presents a summary of (1) caregivers’ knowledge about the care of older people, (2) caregivers’ practice in the care of older people and (3) caregivers’ needs in the care of older people. The analysis reveals that most of the caregivers addressed a lack of knowledge about and poor practice in the care of older people. This review also offers important insight into the needs of caregivers. Hence, this review recommends further studies on knowledge, practice and needs in the care of older people to identify contextual challenges and provide evidence-based solutions to improve caregivers’ knowledge, practice and needs in the care of older people.
29

Folsom, David P., Margaret McCahill, Stephen J. Bartels, Laurie A. Lindamer, Theodore G. Ganiats, and Dilip V. Jeste. "Medical Comorbidity and Receipt of Medical Care by Older Homeless People With Schizophrenia or Depression." Psychiatric Services 53, no. 11 (November 2002): 1456–60. http://dx.doi.org/10.1176/appi.ps.53.11.1456.

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Ward, MC, and P. Higgs. "Psychosocial aspects of adjusting to disability in older people." Reviews in Clinical Gerontology 8, no. 3 (August 1998): 251–56. http://dx.doi.org/10.1017/s0959259898008375.

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Studies across the European Union have noted that chronic illness and chronic disabling conditions rather than acute infectious diseases are now the major causes of morbidity and mortality in member states. This transformation in the nature of health and illness has, and will continue to have, profound effects on the nature of both medicine and the policy and organization of health care. It is estimated that not only will the share of consultations with doctors about issues connected with problems of living with chronic conditions increase, but there will also be a corresponding shift in medical practice from cure to care.
31

Seostianin, Mikołaj. "Towards effective collaboration of physicians and pharmacists on the care of older people." Journal of Medical Science 89, no. 2 (June 30, 2020): e424. http://dx.doi.org/10.20883/medical.e424.

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Collaboration between physicians and pharmacists is essential for proper and effective medical care. Medicine is a multifaceted discipline where success is judged by the final results of the patient’s wellbeing. Incorporating an interdisciplinary education in a medical career enhances the cooperation between future medical professionals. In this comprehensive review, we present current steps which have already been implemented in order to apply interdisciplinary care as well as interprofessional cooperation possibilities during the COVID-19 pandemic.
32

Canham, Sarah, Joe Humphries, Victoria Burns, Tamara Sussman, and Christine Walsh. "Uncovering Promising Practices for Supporting Older People Experiencing Homelessness." Innovation in Aging 4, Supplement_1 (December 1, 2020): 708. http://dx.doi.org/10.1093/geroni/igaa057.2489.

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Abstract Montréal, Calgary, and Vancouver have seen a dramatic increase in homelessness among adults aged 50+. In order to identify ‘promising practices’ that promote aging-in-the-right-place for older people experiencing homelessness (OPEH) in Montréal, Calgary, and Vancouver, we conducted an environmental scan and three World Café workshops with 99 service providers and OPEH. We identified 53 promising practices managed or operated by 42 providers which we categorized across a shelter/housing continuum: 1) Emergency/transitional/temporary shelter/housing; 2) Independent housing with offsite supports; 3) Supported independent housing with onsite, non-medical supports; 4) Permanent supportive housing with onsite medical support and/or specialized services; 5) Long-term care; and 6) Palliative care/hospice. Study findings provide a template for existing solutions to the diverse shelter/housing needs of OPEH and insight into the gaps in shelter/housing and services that would support OPEH to age-in-the-right place. Policy and practice implications for scaling promising practices will be discussed. Part of a symposium sponsored by the Environmental Gerontology Interest Group.
33

Puto, Grażyna, Patrycja Zurzycka, Zofia Musiał, and Marta Muszalik. "Narrative in Older People Care—Concepts and Issues in Patients with Dementia." Healthcare 10, no. 5 (May 12, 2022): 889. http://dx.doi.org/10.3390/healthcare10050889.

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Medical sciences in their classic approach focus on objectively measured dimensions of human functioning and its disorders. Therefore, they are often far removed from the unique identity, experiences and needs of older people. The solution to this type of focusing on the biological, psychological or social dimension of the life of older people may be the inclusion of the narrative in the daily practice of medical care. Narrative medicine supports the development of a holistic approach to care that allows older people to present their own life story, which helps to recognize their uniqueness and to show a genuine interest in the narrative. Attention is increasingly drawn to the fact that the narrative of older people should be recognized and taken into account when planning and providing care in institutions, including long-term care facilities (LTCFs). Despite the fact that LTCFs are often attended by people with multiple diseases and with cognitive impairment, the recognition, respect and maintenance of personal identity should constitute the foundation of caring activities. The basic premise of narration is the recognition that the development of identity does not stop at any age but continues throughout life, and that narrative is an important form of self-expression. The aim of this paper is to present selected issues related to the practice of narrative medicine in caring for older people.
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Korchagina, Irina I., and Lidia M. Prokofieva. "Long-term care needs assessments: French and Russian experience." POPULATION 23, no. 3 (2020): 59–70. http://dx.doi.org/10.19181/population.2020.23.3.6.

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Social support of older people is given a very great attention. In many countries, older people receive long-term care at home. The long-term care (LTC) is actively developed worldwide over the past 20 years. LTC improves the life quality of older people and people with disabilities. Such system includes medical and social services. Currently, in many OECD countries, from a half to three quarters of older people receive long-term care at home. France is one of those countries in which the social support of older people is given a very great attention. In Russia, long-term care is a task of family. Our country is taking first steps in creation of a long-term care system. It is important to take into account the experience of countries that already have specialized social services for older people with loss of autonomy. A new and important element of the LTC system will be a special scale for determining the level of need for long-term care. Such scale helps to differentiate the needs of each elderly person or person with a disability. This paper analyses the methods of determining the level of need for long-term care, used in France and in Russia and describes the advantages and disadvantages of these methods.
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Duffy, Francis. "A Critical Perspective on Advance Care Planning for Older People." British Journal of Social Work 50, no. 4 (August 8, 2019): 1013–30. http://dx.doi.org/10.1093/bjsw/bcz092.

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Abstract How older people plan ahead for ageing in relation to accommodation, care arrangements, healthcare and medical treatment, and end of life decisions has attracted particular attention in recent years and as a result there has been considerable promotion of the importance of planning ahead and executing planning instruments with the aim of making one’s wishes and preferences known in advance. Planning ahead is promoted as allowing older people to have their voices heard, to advance their autonomy, choice and self-determination and to allow them to decide what treatment they may not want to receive. This article provides a critique of advance care planning, based on a subset of findings from a qualitative intergenerational study on ageing in Australia. The findings suggest that advance care planning is a much more complex and at times problematic endeavour, compared to what is promoted about advance care planning, in particular with regard to the use of planning instruments.
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McGraw, Caroline, and Vari Drennan. "Older people and medication management: from compliance to concordance." Reviews in Clinical Gerontology 14, no. 2 (May 2004): 145–53. http://dx.doi.org/10.1017/s0959259804001376.

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The issue of not taking medicines as prescribed by medical practitioners has a history as long as the medical profession itself. The World Health Organization recently described the problem of patients diagnosed with chronic illnesses not taking their medication as prescribed as ‘a worldwide problem of striking magnitude’. Not taking medicines as prescribed has consequences not only for the individual in terms of therapeutic failure, but also for the wider society. For the individual, failure to take medication as prescribed may result in ill health, poorer quality of life, and reduced life expectancy. For the wider society, consequences include avoidable health care expenditure and the development of drug resistance.
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Faulkner, Debbie, and Julia Law. "The ‘unnecessary’ use of emergency departments by older people: findings from hospital data, hospital staff and older people." Australian Health Review 39, no. 5 (2015): 544. http://dx.doi.org/10.1071/ah14185.

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Objective Increasing demands are being placed on emergency departments in Australia and there is a view that older Australians are more likely than other age groups to attend for non-urgent conditions. The objective of this paper is to compare and contrast administrative data with the views of hospital staff and older people with regard to their presentation at two emergency departments in metropolitan Adelaide and how this aligns with the Australian Institute of Health and Welfare definition of ‘potentially avoidable general practitioner-type presentations.’ Methods The study used three sources of data from two emergency departments: hospital data for the financial year 2010–11 for patients aged 65 years and over and identified as triage category four or five; three focus groups with medical, nursing and allied staff from these two hospitals; and interviews with 58 older people who presented at the two emergency departments over a two-week period. Results The hospital administrative data provided a very limited insight into why older people attended the emergency department, other than the medical diagnosis. Professional staff identified individual determinants, societal determinants and the health services system as explanations. Older people attended the emergency department for a range of reasons that may not necessarily reflect the opinions of health professionals. Conclusions For many older people the emergency department was an appropriate place to attend considering their condition, though some presentations could be circumvented with appropriate and increased services in the community. However, as many older people suffer comorbidities, careful consideration needs to be given as to the best possible practices to achieve this. What is known about the topic? Increasing demands are being placed on hospital emergency departments and there are concerns that a growing number of presentations are ‘inappropriate presentations’. Older people are considered to be one group that overuse emergency department services. What does this paper add? Most studies use hospital statistics to examine primary care presentations at emergency departments or present the viewpoints of medical staff within hospitals about the necessity of these visits. This paper compares and contrasts the available data from hospitals, the opinions of medical and allied health professionals and information collected from older people themselves to provide greater insight into why older people triaged as three, four or five attend emergency departments in Adelaide. What are the implications for practitioners? For a range of reasons including availability of quality care, familiarity with hospital services, and a lack of community based services, older people will continue to present to emergency departments. With increasing numbers of older people in the population, hospital emergency departments will need to continuously adapt to accommodate the needs of this older demographic and for staff to acquire necessary geriatric skills.
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Kim, Hwa-Joon, Young Koh, Eun-Jeong Chun, Soong-Nang Jang, and Chang-Yup Kim. "Subjective Satisfaction with Medical Care among Older People: Comprehensiveness, General Satisfaction and Accessibility." Journal of Preventive Medicine and Public Health 42, no. 1 (2009): 35. http://dx.doi.org/10.3961/jpmph.2009.42.1.35.

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Jönsson, Marie, Peter Appelros, and Carin Fredriksson. "Older people readmitted to hospital for acute medical care – Implications for occupational therapy." Scandinavian Journal of Occupational Therapy 24, no. 2 (September 16, 2016): 143–50. http://dx.doi.org/10.1080/11038128.2016.1227367.

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Lui, Nai Lee, and Chek Hooi Wong. "Junior Doctors’ Attitudes Towards Older Adults and its Correlates in a Tertiary-care Public Hospital." Annals of the Academy of Medicine, Singapore 38, no. 2 (February 15, 2009): 125–29. http://dx.doi.org/10.47102/annals-acadmedsg.v38n2p125.

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Introduction: The medical community in Singapore is faced with a rapidly ageing demo- graphic. This would result in an increase in the interaction between medical professionals and older adults. In anticipation of an increased exposure to elderly patients, we sought to determine the attitudes of our house officers (HO), medical officers (MO) and Registrars towards the elderly. Materials and Methods: A descriptive pilot study of junior doctors from the Division of Medicine carried out during a luncheon in the largest tertiary-care public hospital in Singapore. A validated self-administered structured questionnaire using Kogan’s Old People (KOP) Scale was used to evaluate attitudes towards older adults and basic demographics and medical educational data were collected. Results: Fifty-one questionnaires were completed. The mean KOP score was 114.4, suggesting an overall positive attitude towards older people in this sample. The prevalence of negative attitude was 7.8%. There was no significant difference in attitudes among doctors with different designation, age, marital status, medical school attended, nation- ality, years in medical practice and living arrangement. Doctors who had previous exposure with a posting in Geriatric Medicine had higher KOP scores but were just out of significance (P = 0.098). Respondents who found treating older people unrewarding had significantly lower KOP score (P <0.001). Conclusion: In this sample of junior doctors, overall attitudes towards older people as measured by the KOP scale were moderately positive. Exposure to a Geriatric Medicine posting during residency may positively influence a doctor’s attitudes towards the older adults. Key words: Ageing, Attitudes, Elderly, Geriatrics
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Alderman, Chris. "On the Pharmacy Radar: COViD-19 and Older People." Senior Care Pharmacist 35, no. 5 (May 1, 2020): 190–94. http://dx.doi.org/10.4140/tcp.n.2020.190.

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The COVID-19 pandemic presents many medical and social issues for older people. Presented here is a range of information arising from related areas that have impact upon the safety and efficacy of drug therapy in the context of COVID-19. Issues include pharmacy practice, clinical therapeutics, and possible new treatments for the virus. More information will be published in coming issues of The Senior Care Pharmacist.
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Shanahan, Elaine, Alisa Antonenko, Siobhan Kennelly, Chie Wei Fan, and Frances McCarthy. "167 An Alternative to the Emergency Department for Frail Older People." Age and Ageing 48, Supplement_3 (September 2019): iii17—iii65. http://dx.doi.org/10.1093/ageing/afz103.99.

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Abstract Background 53% of hospital inpatient beds are occupied by patients >/= 65 years. These patients often experience functional decline. In those transferred to our post-acute rehabilitation unit the average length of stay prior to transfer is 16 days and 38 days post transfer. Our hospital has a Community Response Unit (CRU) which provides an alternative to this care pathway, offering direct admission to a 15 bed unit with 24-hour medical cover and full multidisciplinary input. This study reviews the use of this unit over a one year period. Methods We retrospectively reviewed the discharge letter or medical notes of patients admitted to the CRU during 2018. The referral source, indication for admission, length of stay and discharge destination were recorded. Results One-hundred and fourteen patients were admitted over the one year period. Source of referral was identified for 81 patients and included day hospitals (53.1%), acute hospitals (14.8%), respite/ transitional care wards (12.3%), nursing homes (8.7%), home visits (6.2%), community sources (3.7%) and other speciality clinics (1.2%). The most common indications for admission were-mobility/functional decline (26.3%), falls (17.5%), requirement for medical investigations (14.9%), cognitive decline with behavioural issues (11.4%), blood transfusion (10.5%), pain management (7%), general deterioration (7%), requirement for increased home supports (7%), treatment of infection (6.1%), rehab post fracture (5.3%), wound management (4.4%), alcohol detoxification (1.8%) and self-neglect (1.8%). Multifactorial reasons for admission frequently occurred. The median length of stay was 24 days (1-176 days), 67% of patients were discharged to their original residence, 17.4% were newly admitted to residential care, 9.2% required transfer to an acute hospital and 6.4% died during their admission. Conclusion The CRU provides comprehensive Geriatrician led care for a wide variety of indications. This model of care offers a valid alternative to Emergency Department presentation and acute hospital admission.
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Bakirova, E. A. "Problems of medical support for persons over working age (by the example of the Republic of Tatarstan)." Manager Zdravoochranenia, no. 10 (January 17, 2023): 71–76. http://dx.doi.org/10.21045/1811-0185-2022-10-71-76.

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Currently, most countries are showing a demographic trend characterized by an increase in the number of older people. In Russia, there is also a significant aging of the population, in connection with which, the number of people older than working age seeking medical care is growing every year. At the same time, the need is growing not only for treatment and rehabilitation, but also for the prevention of diseases, the implementation of active longevity programs. All this emphasizes the relevance and necessity of high-quality and sufficient medical support for this category of people. Purpose: to study the features of medical support for people older than working age on the example of the Republic of Tatarstan. Materials and methods: the data of official statistics, including those of the Ministry of Health of the Republic of Tatarstan, were used in the work. Analytical, statistical, mathematical research methods were used. Findings: To create optimal resource provision in the provision of medical care to people older than working age, it is necessary to: introduce new indicators of the state of health, increase the number of geriatricians, increase the number of geriatric beds, not reduce therapeutic beds, constantly increase the coverage of preventive medical examinations, medical examinations of people older than working age age, based on their share in the population structure (at least 25%).
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Karlsson, Staffan, Anna-Karin Edberg, Albert Westergren, and Ingalill Rahm Hallberg. "Older People Receiving Public Long-Term Care in Relation to Consumption of Medical Health Care and Informal Care." Open Geriatric Medicine Journal 1, no. 1 (February 8, 2008): 1–9. http://dx.doi.org/10.2174/1874827900801010001.

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Mckelvie, S. "536 NEGOTIATING INDIVIDUALLY TAILORED URGENT CARE PLANS FOR OLDER PEOPLE IN AMBULATORY EMERGENCY CARE." Age and Ageing 50, Supplement_2 (June 2021): ii1—ii4. http://dx.doi.org/10.1093/ageing/afab117.13.

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Abstract Introduction Ambulatory emergency care (AEC) provides hospital-equivalent medical care in out-of-hospital settings for acutely unwell complex older patients. This ethnography aimed to understand the cognitive work of the senior clinicians in the AEC environment. Methods Three AEC sites were purposively sampled to recruit twelve clinicians with backgrounds in Geriatrics, General Practice, Emergency and Acute Medicine. This qualitative investigation used focused ethnography within a case study approach to understand the decision-making processes in the context of the AEC environment. Participant-observation during an AEC shift was complemented by informant interviews. A framework approach to thematic analysis used a priori and data derived codes to develop explanatory themes. Ethnographic principles of constant comparison and cognitive task analysis were used to evaluate the clinicians’ decision-making processes for index patient cases. Results This ethnographic case study showed that AEC clinicians tailored their management plans to the individual patient based on their clinical assessment and needs, using creative problem solving and reflexivity. The AEC clinicians personalised their interventions based on the patient assessment, the patients’ wishes and disease severity. The individual tailoring of the AEC plan was negotiated with the patient, their next-of-kin and the multidisciplinary team (MDT). The discussions with patient and families allowed discussion of the differing priorities and facilitated compromise. AEC plans were also negotiated with the MDT to build a shared understanding of the patients’ needs. The MDT also provided cognitive and emotional support by challenging and validating the senior decision-makers clinical plans. Conclusion This tailored approach allowed the flexible delivery of AEC to meet the patients’ needs. It is hoped that by characterising the work of AEC clinician that this study will aid the development of medical training curricula, interdisciplinary working and health service design. Further research is needed on team-based decision-making for individually tailored care in urgent care settings.
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Linichenko, Yu V., A. B. Zudin, O. E. Konovalov, and M. D. Vasiliev. "OPINION OF OLDER AGE GROUPS OF MEDICAL, SOCIAL AND GERIATRIC CARE." NAUKA MOLODYKH (Eruditio Juvenium) 9, no. 1 (March 31, 2021): 44–50. http://dx.doi.org/10.23888/hmj20219144-50.

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Background. The article deals with measures for providing medical and social assistance with the aim of preservation of health, improvement of the quality of life of the elderly and senile, and of their adaptation in the society. Aim. study of the opinion of elderly and senile people of the rendered medical, social and geriatric care. Materials and Methods. A survey of 456 residents of the Moscow region older than working age was conducted. All respondents at one time were patients of the Moscow Regional Hospital of Wars Veterans. Results. The majority of respondents noted availability of various types of medical care, but only a small part of them evaluated its quality positively. Among the reasons for dissatisfaction, the most frequently cited were the lack of specialist doctors, spending much time in the waiting room in visiting therapists and narrow specialists, ineffective treatment, payment for necessary medical services, waiting lists for inpatient treatment, and in some cases violation of the patients rights. Dissatisfaction with medical and social assistance was mainly related to the problems of disability registration and implementation of individual rehabilitation programs. Conclusion. The results of the survey for studying satisfaction of older people with medical, social and geriatric care should be used for elaboration of proposals for its improvement.
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Forbat, Liz, Michael Chapman, Clare Lovell, Wai-Man Liu, and Nikki Johnston. "Improving specialist palliative care in residential care for older people: a checklist to guide practice." BMJ Supportive & Palliative Care 8, no. 3 (August 2, 2017): 347–53. http://dx.doi.org/10.1136/bmjspcare-2017-001332.

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ObjectivesPalliative care needs rounds are triage meetings that have been introduced in residential care for older adults to help identify and prioritise care for people most at risk for unplanned dying with inadequately controlled symptoms. This study sought to generate an evidence-based checklist in order to support specialist palliative care clinicians integrate care in residential nursing homes for older people.MethodsA grounded theory ethnographic study, involving non-participant observation and qualitative interviews. The study was conducted at four residential facilities for older people in one city. Observations and recordings of 15 meetings were made, and complimented by 13 interviews with staff attending the needs rounds.ResultsThe palliative care needs round checklist is presented, alongside rich description of how needs rounds are conducted. Extracts from interviews with needs rounds participants illustrate the choice of items within the checklist and their importance in supporting the evolution towards efficient and effective high-quality specialist palliative care input to the care of older people living in residential care.ConclusionsThe checklist can be used to support the integration of specialist palliative care into residential care to drive up quality care, provide staff with focused case-based education, maximise planning and reduce symptom burden for people at end of life.
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Yous, Marie-Lee, Lori Schindel Martin, Sharon Kaasalainen, and Jenny Ploeg. "Low investment non-pharmacological approaches implemented for older people experiencing responsive behaviours of dementia." SAGE Open Nursing 6 (January 2020): 237796082096462. http://dx.doi.org/10.1177/2377960820964620.

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Introduction The acute care setting is not ideal for older people with dementia; responsive behaviours may be triggered when care is delivered within a strange environment by staff with limited knowledge of life history and personal preferences. Responsive behaviours (e.g., yelling, hitting, restlessness) are used by older people with dementia to communicate their needs and concerns. It is unknown whether non-pharmacological approaches used by nurses support the development of a meaningful interpersonal relationship between nurses and older people with dementia. Aims: The aims of this study were to explore: (a) the types of low investment non-pharmacological approaches (e.g., music, social activities) used by nurses caring for older people experiencing responsive behaviours of dementia in acute medical settings and (b) the factors that influence the decisions of these nurses to implement these approaches. Methods We present a qualitative secondary analysis of data from a primary study using Thorne’s interpretive description approach. Interviews were conducted with 11 nurses and four allied health professionals from acute medical settings in Canada. A qualitative secondary data analytic approach was used, specifically analytic expansion, and experiential thematic analysis. Findings: egardless of the educational preparation of nurses, the decision to use specific types of low investment non-pharmacological approaches were influenced by the perfunctory development of the interpersonal relationships in acute care hospitals. The factors that led nurses to use limited approaches (e.g., turning on the TV and providing a newspaper) were lack of dementia care education and attending to other acutely ill clients. Conclusions: This study revealed that nurses in acute medical settings require greater practice growth to deliver relational care which is crucial to supporting older people with dementia. Nurses need education and knowledge translation support to use creative low investment non-pharmacological approaches with the intent on upholding the quality of life older people with dementia.
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O’Reilly, Sinead. "Decision making on clinical care choices including end-of-life decision making for older adults in an acute care setting." British Journal of General Practice 70, suppl 1 (June 2020): bjgp20X711725. http://dx.doi.org/10.3399/bjgp20x711725.

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BackgroundThe Scottish Government’s vision for older people is that ‘Older people are valued as an asset; their voices are heard and they are supported to enjoy full and positive lives.’ In the health and social care setting in Scotland it is increasingly recognised that there is a need for careful planning of care for older patients with complex comorbidities, and that this should involve the patient where possible via a process of shared decision making (SDM).AimTo establish what future planning for healthcare decision making and end-of-life care was undertaken in the care of the older patients in a secondary care facility, and how much they participate in this process.MethodAn audit was conducted across four wards in the care of the older patient setting in a hospital for older patients in Scotland. Over a 2-week period, all patients’ charts (n = 82) were reviewed, and evidence was examined on whether the following documents were in place: a do not resuscitate order; an escalation of medical care plan; and an assessment of capacity/incapacity.ResultsThe majority of patients (55%) had a resuscitation plan in place. An Incapacity Statement was also in place for the majority of patients who required it (90%). The escalation of medical care plan was only completed for a minority of patients, mainly those on the palliative care ward.ConclusionPlans for decision making around resuscitation were reasonably well developed. However, planning for other, more complex, future medical care needs was less well defined or explored with older patients.
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Supaporn, Kanyanat, Sang-arun Isaramalai, and Wandee Suttharangsee. "Exploring caregivers' perspectives on improving care for older people at the end of life in Thailand." International Journal of Palliative Nursing 25, no. 7 (July 2, 2019): 326–32. http://dx.doi.org/10.12968/ijpn.2019.25.7.326.

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Background: Older people in Thailand receive general medical and social care at the end of life, and many rarely access palliative services. In light of this, improving the quality of care for the ageing population relies on addressing the needs of family caregivers, who provide the majority of care in a home setting. Understanding caregivers' perspectives when caring for a friend or relative will help to improve the quality of care that they provide. Aim: To explore caregivers' perspectives on improving care for older people in Thailand in the palliative stage. Methods: A qualitative study using in-depth interviews and observation of 10 older people in the palliative stage and their caregivers was undertaken. Data were analysed using content analysis. Findings: Data analysis revealed three themes: caregivers cared to repay the older person's previous kindness, caregivers cared and changed their caregiving behaviour to minimise the older person's perception of being abandoned or being a burden, and to follow Thai ancestral traditions, so that the older person could die peacefully. Conclusion: This study provides specific instructions for those who provide care for older Thai people in the palliative stage. Finding ways to address caregivers' perspectives on improving care quality could enhance the experience of care recipients.
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