The Admission of Older Patients with COVID-19 in the General Wards

Health Care Facilities for Senior Citizens in Selected Tertiary Hospitals During Covid-19 Pandemic

Journal of Preventive and Social Medicine ◽

10.3329/jopsom.v40i1.56691 ◽

2022 ◽

Vol 40 (1) ◽

pp. 51-58

Author(s):

Sathi Binte Ali ◽

Mohammad Asraful Alam

Keyword(s):

Health Care ◽

Elderly Patients ◽

Older Patients ◽

Geriatric Patients ◽

Senior Citizens ◽

Health Care Facilities ◽

Geriatric Ward ◽

Care Facilities ◽

Tertiary Hospitals ◽

General Wards

Background: To assess the health care facilities provided for senior citizens in selected tertiary hospitals. Methods: This descriptive type of cross-sectional study was carried out among service providers (doctors and nurses) and hospital administrators within the period of January to December 2020. A total of 305 respondents was selected purposively. Semi structured questionnaire and observational checklist was used to collect data. Data was collected by face to face interview and observation. Data was analyzed by using SPSS (Statistical Package for Social Science) software version 25. Results: Among participants, Administrator 2.6%, Doctor 25.2% and Nurse 72.1%. Mean age of the respondents was 32.72±7.67 years. Most of the respondents 90.8% working experience less than 10 years and their average monthly income was Tk. 35398.90±16509.12. In DMCH separate geriatric ward present but in BSMMU geriatric ward absent. Rehabilitation center & long-term care facilities for elderly patients, telemedicine service, separation facility for non COVID geriatric patients from COVID positive patients, free care facility for poor elderly patients, social welfare support facilities present in both hospitals. Separate bed facility in general wards, geriatric ICU and COVID ward absent, training facility on geriatric health absent in both hospitals. Majority of the respondents 97.0% take consent before any procedure, 89.6% service provider involve geriatric patients in decision making about their care and treatment, 56.6% respondents follow polypharmacy guideline. Opinion regarding utility service was average. Opinion regarding diagnostic facilities, essential drugs, sterilization facilities, of this hospital for senior citizens was moderately sufficient 50.5%, 60.6% and 59.3% respectively and ambulance service insufficient 53.4%. Among respondents 89.8% face barriers in providing geriatric health care. Opinion regarding the existing health care facilities for senior citizens of this hospitals insufficient 52.8%. Regarding improvement of health care services 26.0% mentioned that training of doctor/ nurses followed by separate geriatric ward facilities for geriatric patients 20.8%, increase the number of supporting staff 16.2%, free health care facilities for poor elderly patients 11.8%, training of supporting staffs 10.6%, training for informal/family caregiver 7.4%, separate bed for geriatric patient in general wards 6.4% and the rest others mentioned 0.7%. Analysis found statistically significant association between national guideline follow for the treatment and care of older patients and their educational qualification (0.001), designation (p=0.001), polypharmacy guideline follows for the treatment and care of older patients and their designation, referral guideline follows for geriatric patients and their designation (p=0.001). Conclusion: To provide quality healthcare service to the senior citizens of Bangladesh, geriatric health care should be given highest priority. JOPSOM 2021; 40(1): 51-58

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Association of Window-side bed Admission with Delirium Suppression in General wards: A Cohort Study of Older Inpatients

10.21203/rs.3.rs-144531/v1 ◽

2021 ◽

Author(s):

Daiki Aomura ◽

Yosuke Yamada ◽

Makoto Harada ◽

Koji Hashimoto ◽

Yuji Kamijo

Keyword(s):

Cohort Study ◽

Older Patients ◽

Retrospective Cohort ◽

Cox Regression ◽

Physical Restraint ◽

General Ward ◽

University Hospital ◽

Patient Room ◽

Older Inpatients ◽

General Wards

Abstract Delirium is a serious problem among older inpatients. Windows in intensive care unit wards may reportedly suppress delirium, with some guidelines recommending the assignment of delirious inpatients to window-side beds. However, whether window-side bed placement suppresses delirium in general wards remains unknown. We therefore performed a retrospective cohort study of 1556 patients who were: 1) admitted to internal medicine departments in Shinshu University Hospital, Japan, between 2009 and 2018, 2) older than 75 years, 3) admitted to a multi-patient room in a general ward, and 4) admitted unexpectedly. We compared 495 patients assigned to a window-side bed (window group) with 1061 patients assigned to a non-window-side bed (non-window group). The main outcome was delirium with event (e.g. use of anti-delirium medication or physical restraint) within 14 days after admission, which was recorded in 11.1 and 12.1 patients per thousand person-days in the window and non-window group, respectively. Multivariate analysis adjusting for potential confounders including the severity of patient’s illness with Cox regression modeling revealed no remarkable association for the window group with outcome development (adjusted hazard ratio 0.90, 95% confidence interval: 0.61–1.34). Thus, admission to a window-side bed may not prevent delirium in older patients admitted to a general ward.

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Risk factors for postoperative delirium and subsyndromal delirium in older surgical patients in the general ward: a prospective observational study

10.21203/rs.3.rs-44194/v1 ◽

2020 ◽

Author(s):

Maya Kanno ◽

Mana Doi ◽

Kazumi Kubota ◽

Yuka Kanoya

Keyword(s):

Risk Factors ◽

Observational Study ◽

Odds Ratio ◽

Older Patients ◽

Postoperative Delirium ◽

Prospective Observational Study ◽

General Ward ◽

Subsyndromal Delirium ◽

Laboratory Test Results ◽

General Wards

Abstract Background Postoperative delirium (POD) among older patients is a common, serious disease and is associated with a high incidence of negative outcomes. For early detection of POD and subsyndromal delirium (SSD), this study was conducted to identify risk factors of POD and SSD in older patients in a general ward who were scheduled for surgery. Methods This was a prospective observational study. Study participants were older than 65 years, underwent urology surgery, and were hospitalized in the general ward between April and September 2019. Both POD and SSD were assessed by using the Confusion Assessment Method on the preoperative day, the day of surgery, and postoperative days 1–3. Personal characteristics, clinical data, cognitive function, physical functions, laboratory test results, medication use, type of surgery and anesthesia, and use of restraints were collected from medical records. Univariate and multivariate analyses were conducted to identify the risk factors for POD and SSD. Results A total of 101 participants (mean age 74.9 years) were enrolled; 19 (18.8%) developed POD and SSD. The use of bed sensors (odds ratio 10.2, p = .001) and preoperative level of C-reactive protein (CRP; odds ratio 1.5, p = .054) were identified as risk factors for POD and SSD. Conclusions POD and SSD among older patients in general wards were related to bed sensor use and the preoperative CRP level. Therefore, this study suggests that in order prevent POD and SSD for older patients in general wards, it is necessary to avoid bed sensor use as restraints and to assess the preoperative CRP level.

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Aging and Autism

Perspectives on Gerontology ◽

10.1044/gero17.2.69 ◽

2012 ◽

Vol 17 (2) ◽

pp. 69-75 ◽

Cited By ~ 1

Author(s):

Pamela A. Smith

Keyword(s):

Health Care ◽

Autism Spectrum Disorders ◽

Patient Group ◽

Older Patients ◽

Geriatric Patients ◽

Recent Literature ◽

Communication Disorders ◽

Autism Spectrum ◽

Need For Support ◽

Spectrum Disorders

In this article, I will review the available recent literature about the aging population with autism, a patient group that researchers know little about and a group that is experiencing a growing need for support from communication disorders professionals. Speech-language pathologists working with geriatric patients should become familiar with this issue, as the numbers of older patients with autism spectrum disorders is likely to increase. Our profession and our health care system must prepare to meet the challenge these patients and residents will present as they age.

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