scholarly journals What Older Patients and their Relatives Say is Important During Acute Hospitalisation: A Qualitative Study

2021 ◽  
Author(s):  
Nina Mickelson Weldingh ◽  
Marit Kirkevold
Keyword(s):  
Hospital Stay ◽  
Older Patients ◽  
Quality Care ◽  
The Elderly ◽  
Care Patient ◽  
University Hospital ◽  
Individual Values ◽  
Care For The Elderly ◽  
Acute Hospitalisation ◽  
Individualised Care

Abstract Background: Due to the growing elderly population across the world, providing safe and effective care to older people is an increasing concern. Hospitals need to adapt to ensure high-quality care for older patients. Several age-friendly frameworks and models aiming at reducing risks and complications have been promoted. However, care for the elderly must be based on the patients’ reported needs, and relatives are often an important part of the patients’ resources. The primary aim of this study was to explore elderly patients’ and their relatives’ experiences of acute hospitalisation and determine what is important for them to experience a good hospital stay. Methods: This study has a qualitative research design in which patients aged 75 years or older and their relatives were interviewed during their acute hospitalisation. The study was conducted at two medical bed wards at a large university hospital in Norway. All interviews were thematically analysed.Results: Four major themes were identified in patients’ and relatives’ descriptions of how they experienced the hospital stay and what was important for them during the hospital stay: being seen and valued as a person, individualised care, patient-adapted communication and information, and collaboration with relatives. The themes span both positive and negative experiences, reflecting great variability in the experiences described.Conclusions: The results underscore how small things matter in relation to how we meet and communicate with older patients and their relatives. How health personnel get to know the patient’s individual values, need for care, information and involvement of relatives affects their experiences of the hospital stay.

scholarly journals Challenges and technologies of care developed by caregivers of patients with Alzheimer's disease

2018 ◽  
Vol 21 (5) ◽  
pp. 579-587
Author(s):  
Melanie Scheneider Schmidt ◽  
Melissa Orlandi Honório Locks ◽  
Karina Silveira de Almeida Hammerschmidt ◽  
Darla Lusia Ropelato Fernandez ◽  
Francisco Reis Tristão ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Elderly People ◽  
Quality Care ◽  
The Elderly ◽  
Structured Interview ◽  
University Hospital ◽  
Mutual Help ◽  
Care For The Elderly ◽  
South Of Brazil

Abstract Objective: to identify the challenges and technologies of care developed by caregivers of patients with Alzheimer's disease. Method: an exploratory study with a qualitative approach was carried out with nine caregivers of elderly people with Alzheimer's disease from the mutual help group of a university hospital in the south of Brazil. Data collection took place between May and August 2017 through a semi-structured interview. Content analysis was used to analyze the data. Results: two categories emerged from the analysis of the data: the challenges faced by caregivers of elderly people with Alzheimer's Disease and the care technologies developed by caregivers of elderly people with Alzheimer's disease. Conclusion: the study showed that the care strategies elaborated by the caregiver can enhance understanding, reflection and discussion among health professionals, caregivers and family members about quality care for the elderly and minimize the difficulties of care in order to provide greater quality of care for the elderly.

scholarly journals Care and management demands of long-term care facilities for the elderly in Brazil: an integrative review (2004-2014)

2017 ◽  
Vol 20 (2) ◽  
pp. 286-299 ◽  
Author(s):  
Fátima Ferreira Roquete ◽  
Carolina Campos Ricci Frá Batista ◽  
Rodrigo Caetano Arantes
Keyword(s):  
Long Term Care ◽  
Quality Care ◽  
The Elderly ◽  
Integrative Review ◽  
Elderly Persons ◽  
Term Care ◽  
Care For The Elderly ◽  
Care Facilities ◽  
Care Demands

Abstract Objective: to analyze the care and management demands of Long-Term Care Facilities for the Elderly (LTCFs) in Brazil. Method: an integrative review of literature was carried out, organized into six stages: a) elaboration of a guiding question; b) online search of LILACS, SciELO, PubMed, the CAPES Portal and the Brazilian Society of Geriatrics and Gerontology databases; c) article selection, following the exclusion and inclusion criteria, with the sample composed of 17 articles; d) commented analysis of the selected articles; e) deliberation on the results obtained, formulated from the synthesis and interpretation of the selected studies; f) presentation of the results of the review. Results: the care demands identified are related to the process of caring and assume a working team with geriatric and gerontological knowledge, while the management demands include the means and resources needed so the care can be provided effectively. However, the LTCFs were found to rely on professionals who are unprepared to provide care or to assume an organizational management role, meaning care for the elderly is restricted to the essentials for their basic needs. Conclusion: the care demands were easily identified in the analyzed publications, however, there is a lack of research that evaluates management demands in a broader and more in-depth manner. It is suggested that studies aiming to broaden theoretical knowledge of the care and management demands of LTCFs are carried out, to stimulate effective and positive actions in the practices of these institutions, seeking to offer top quality care to elderly persons that live in these facilities, that responds to the real needs of their current stage of life.

scholarly journals Difficulties encountered in care for elderly persons with dementia: coping based on participatory research

2018 ◽  
Vol 21 (1) ◽  
pp. 35-43
Author(s):  
Barbara Martins Corrêa da Silva ◽  
Célia Pereira Caldas ◽  
Helena Maria Shchelowski Leal David ◽  
Michel Jean Marie Thiollent
Keyword(s):  
Family Caregivers ◽  
Participatory Research ◽  
Action Plan ◽  
Elderly Care ◽  
The Elderly ◽  
University Hospital ◽  
Support Network ◽  
Elderly Persons ◽  
Care For The Elderly ◽  
People With Dementia

Abstract Objective: to analyze the proposal of an action plan created by nurses to deal with difficulties in caring for the elderly. The aim of the present study was therefore to analyze the difficulties that family caregivers find in relation to access to services, material resources and the support network when meeting the care needs of the elderly in accordance with Brazilian public policy. Method: the methodology of participatory research and content analysis proposed by Bardin was used. The context was the Geriatric service of a university hospital. The group of co-researchers included eight nurses and 12 caregivers of elderly people with dementia. Results: the following categories emerged from the analysis: contradictions and work proposals. The contradictions category revealed reflections about the difference between the proposed care for the elderly and the reality of a lack of care and the precarious conditions of health services. This situation leads to overburdening of caregivers. The work proposals refer to the strategies used by nurses to establish a relationship of support to family caregivers to cope with the difficulties involved in care for the elderly. Conclusion: nurses recognize that they are professionals capable of receiving, listening to and managing the needs of family caregivers of the elderly, thus promoting the health of the elderly and the caregivers themselves, preparing the family of the patient for home care and coping with difficulties experienced in elderly care.

scholarly journals Differential Management Strategies and Outcomes in Patients over 65 years with Acute Calculous Biliary Disease—Results and Insights from the ESTES Complicated Biliary Calculous Disease Snapshot Audit

2020 ◽  
Author(s):  
Gary Alan Bass ◽  
Amy E. Gillis ◽  
Yang Cao ◽  
Shahin Mohseni ◽  
ESTES Cohort Studies Collaborative Group
Keyword(s):  
Surgical Treatment ◽  
Elderly Patients ◽  
Hospital Stay ◽  
Older Patients ◽  
Operative Mortality ◽  
The Elderly ◽  
Operative Intervention ◽  
Ageing Population ◽  
Biliary Disease ◽  
Elderly Cohort

Abstract Background: Acute complicated calculous biliary disease (ACCBD) may pose challenges in an ageing population. Frailty and comorbidities increase the potential risks of surgery; thus, surgeons may opt to offer operative treatments less often to their older patients. We set out to capture the incidence and treatment algorithms used across Europe to treat older patients presenting with ACCBD.Methods: Analysis of the European Society of Trauma and Emergency Surgery (ESTES) 2018 Acute Complicated Calculous Biliary Disease audit was performed. Patients undergoing emergency hospital admission with ACCBD between 1 October 2018 and 31 October 2018 were included. The primary outcome measure was operative intervention in patients over and under 65 years of age. Mortalities, post-operative morbidity, time to operative intervention, post-acute disposition and length of hospital stay were measured as secondary outcomes.Results: The median age of the 338 patients admitted to the snapshot was 67 years; 185 patients (54.7%) were over 65 years at time of admission. Significantly fewer patients over 65 underwent definitive surgical treatment, compared with those under 65 (37.8% vs. 64.7%, p <0.001). Surgical complications were seen more frequently in the over 65 cohort. Post-operative mortality was seen in 2.2% of over 65s versus 0.7% under 65(p=0.253). Mean post-operative length of stay was significantly longer in the elderly cohort. In patients surviving to discharge, post-acute convalescence or rehabilitation was required in 13.3% in the elderly cohort versus 1.9% of those under 65 (p=0.002).Conclusions: Elderly patients commonly present with ACCBD. Increased frailty and incidence of comorbid disease in this population increases the potential surgical risk. In our snapshot, elderly patients represented the majority, but far fewer were offered definitive surgical treatment. Post-operative mortality, morbidity, length of post-operative in-hospital stay and the requirement for post-discharge convalescence were higher in this group.

scholarly journals Building the Universidad Nacional de Colombia Hospital: Reconciling social and academic aspects

2015 ◽  
Vol 62 (4) ◽  
pp. 641-646 ◽  
Author(s):  
Juan Carlos García-Ubaque
Keyword(s):  
Quality Care ◽  
The Elderly ◽  
Chronic Illnesses ◽  
University Hospital ◽  
Academic Needs ◽  
Care Needs ◽  
National University ◽  
Epidemiological Profile ◽  
The University ◽  
The City

<p>In the process of building the National University Hospital, an<br />analysis of the changing epidemiological profile of the population of Bogotá was undertaken, which examined the health care needs of the city, the academic needs of the university and institutional possibilities. It was made an analysis of the demographic and epidemiological profile of the population of Bogotá.</p><p><br />It was concluded that there were factors associated with the<br />epidemiological transition of aging, such as a low availability<br />of health services for the elderly and diseases related to that<br />care. Just as in the university, the hospital needs to develop<br />all aspects of patient care to be able to adequately respond<br />to the needs of this demographic from an interdisciplinary<br />perspective, ensuring quality care based on the criteria of<br />timeliness, accessibility, relevance, sufficiency, and continuity.</p><p>A proposal is outlined concluding that the first phase of the<br />portfolio of services that the University Hospital offers must<br />be geared towards geriatric care and chronic illnesses, due to<br />the aging of the general population as a result of a decline in<br />fertility and mortality. This care would cater towards so-called<br />permanent conditions that result in disability, or not easily<br />reversible physiopathological conditions that require longterm<br />care, as well as special training in secondary prevention<br />and rehabilitation for the patient and the family.</p>

scholarly journals Fatores extrínsecos para risco de quedas de idosos hospitalizados

2018 ◽  
Vol 12 (7) ◽  
pp. 1835
Author(s):  
Bárbara Jeane Pinto Chaves ◽  
Jacira Dos Santos Oliveira ◽  
Mayara Muniz Peixoto Diniz ◽  
Renata Maia de Medeiros Falcão ◽  
Suzanna Valeria Oliveira de Souza ◽  
...  
Keyword(s):  
The Elderly ◽  
University Hospital ◽  
Extrinsic Factors ◽  
Care For The Elderly ◽  
Hospitalized Elderly ◽  
Factores De Riesgo ◽  
Version 2.0 ◽  
Hospitalized Elderly Patients ◽  
Mean Time ◽  
Surgical Clinic

RESUMO Objetivo: identificar os fatores extrínsecos favoráveis à ocorrência de quedas de pacientes idosos hospitalizados. Método: estudo quantitativo, documental, retrospectivo e descritivo realizado a partir da coleta de registros no livro de admissão e alta dos pacientes internados na unidade de clínica cirúrgica de um Hospital Universitário. A amostra reuniu 424 idosos internados no período de janeiro a dezembro de 2015. Os dados foram digitados no Excel e analisados no Programa SPSS, versão 2.0., e os resultados, apresentados em tabelas. Resultados: o perfil dos idosos mostrou maioria para o sexo feminino 227 (54%), uma média de idade 71,6 anos, com maiores números de internamento em fevereiro 55 (13%), média de tempo de 4,8 dias e motivo da saída 351 (83%) por alta hospitalar. Consideraram-se oito (62%) enfermarias como ambientes seguros, embora quatro (31%) enfermarias tinham excesso de móveis. Conclusão: conhecer o perfil dos idosos e os fatores extrínsecos possibilitará, aos profissionais de saúde, identificar os riscos e prover a assistência segura ao idoso. Descritores: Idoso; Hospitalização; Acidentes por quedas; Assistência de Enfermagem; Envelhecimento; Fatores de Risco.ABSTRACT Objective: to identify the extrinsic factors favorable to the occurrence of falls in hospitalized elderly patients. Method: quantitative, documental, retrospective and descriptive study carried out from the collection of records in the admission and discharge book of the patients hospitalized in the unit of surgical clinic of a University Hospital. The sample consisted of 424 elderly hospitalized from January to December 2015. The data were entered in Excel and analyzed in the SPSS Program, version 2.0., And the results, presented in tables. Results: the profile of the elderly showed a majority of females 227 (54%), mean age 71.6 years, with higher admission numbers in February 55 (13%), mean time of 4.8 days and motive of exit 351 (83%) due to hospital discharge. Eight (62%) wards were considered safe environments, although four (31%) wards had excess furniture. Conclusion: knowing the profile of the elderly and the extrinsic factors will enable health professionals to identify the risks and provide safe care for the elderly.  Descriptors: Aged; Hospitalizacion; Accidental Falls; Nursing Care; Aging; Risk Factors,RESUMEN Objetivo: identificar los factores extrínsecos favorables a la ocurrencia de caídas de pacientes ancianos hospitalizados. Método: estudio cuantitativo, documental, retrospectivo y descriptivo realizado a partir de la recolección de registros en el libro de admisión y alta de los pacientes internados en la unidad de clínica quirúrgica de un Hospital Universitario. La muestra se reunió 424 ancianos internados en el período de enero a diciembre de 2015. Los datos fueron digitados en Excel y analizados en el Programa SPSS, versión 2.0, y los resultados, presentados en tablas. Resultados: el perfil de los ancianos mostró la mayoría para el sexo femenino 227 (54%), una media de edad 71,6 años, con mayores números de internamiento en febrero 55 (13%), y media de tiempo de 4,8 días y motivo de la salida 351 (83%) por alta hospitalaria. Se consideraron ocho (62%) enfermeras como ambientes seguros, aunque cuatro (31%) de las enfermerías tenían exceso de muebles. Conclusión: conocer el perfil de los ancianos y los factores extrínsecos, posibilitar, a los profesionales de salud, identificar los riesgos y proveer la asistencia segura al anciano. Descriptores: Anciano; Hospitalizaciòn; Accidentes por Caídas; Atencion de Enfermarìa; Envejecimiento; Factores de Riesgo.

Improving Health Literacy at the Organizational Level

2020 ◽  
Vol 13 (1) ◽  
pp. 79-83
Author(s):  
Denise Isibel
Keyword(s):  
Health Literacy ◽  
Quality Care ◽  
The Elderly ◽  
Healthcare Services ◽  
Healthcare Research ◽  
Organizational Level ◽  
Health Care Information ◽  
Universal Precautions ◽  
Care Givers ◽  
Care For The Elderly

BackgroundThe lack of health literacy is associated with higher mortality, more frequent hospitalizations, and increased use of healthcare services. Organizations must create an environment that prepares a workforce with a heightened sensitivity for health literacy.ObjectiveThe local Program of All Inclusive Care for the Elderly (PACE) program desired to have an organized plan to address health literacy.MethodsTwelve interdisciplinary team members of a Program for all Inclusive Care of the Elderly completed the Assessment Questionnaire from the Agency for Healthcare Research and Quality (AHRQ) Health Literacy Universal Precautions Toolkit. Once the questionnaire was complete organizational priorities were identified and the AHRQ Toolkit was utilized to develop next steps.ResultsThe organization identified three areas as priorities: development of a health literacy team, improving spoken communication with patients and care givers, and improving written information given via letters and home instructions.ConclusionsOrganizations, nursing, and quality care leaders may find these results useful to assess organizational literacy and develop improvement plans.Implications for NursingImplementation of the AHRQ Health literacy Universal Precautions toolkit may increase understanding and training health literacy, improve passage of health care information and increase patient safety.

Polypharmacy among elderly populations

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S315
Author(s):  
I. Leal ◽  
P. Ordás ◽  
R. Vicente ◽  
C. Avila
Keyword(s):  
Older Patients ◽  
Psychiatric Illness ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
University Hospital ◽  
Potentially Inappropriate Medications ◽  
Potentially Inappropriate Prescribing ◽  
Cross Sectional

IntroductionPotentially inappropriate prescribing, is highly prevalent among older patients hospitalized with major psychiatric illness. Inappropriate use of psychotropic medications in elderly patients has become a focus of concern.ObjectivesTo determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), according to STOPP-START, Beers and PRISCUS criteria applied by CheckTheMeds®.AimsTo identify potentially IP, PPo and the prevalence of contraindications, interactions and precautions in older patients hospitalized with major psychiatric illness.MethodsRetrospective cross-sectional study with patients over 65 discharged from the Psychiatric acute unit of the university hospital of La Princesa (Madrid) between January 2013 and October 2015 was conducted. The CheckTheMeds® program was used to identify IP.ResultsA total of 104 elders–74 females and 30 males–were included, with a mean age of 76 years (range: 65–91). An average of 5.73 (range: 1–16) was prescribed drugs at discharge. The Ip results STOPP 81.73% (n = 85), START 43.26% (n = 45), Beers 94.23% (n = 98) y PRISCUS 40.38% (n = 42). Contraindications were described in the 21.15% of the patients, precautions in 83.65% and interactions in 83.65%. Psychotropic drugs were the most often inappropriate prescribed medicaments.ConclusionPrescribing omissions are twice as prevalent as IP in the elderly. Currently, inappropriate prescription of psychotropic agents is very common for the elderly. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilization and cost and nonpharmacological interventions, should be thoroughly explored.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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