scholarly journals Malnutrition Prevention

2021 ◽  
pp. 51-64
Author(s):  
Patrick Roigk ◽  
Fabian Graeb
Keyword(s):  
Older Adults ◽  
Interdisciplinary Team ◽  
Later Life ◽  
Nutritional Intake ◽  
Evidence Based ◽  
Healthcare Settings ◽  
Pressure Injury ◽  
Hospital Stays ◽  
Poor Outcomes

AbstractA healthy nutritional intake is required to prevent malnutrition. Furthermore, nutrition is associated with improved quality of life in older adults. Simultaneously, many factors influence nutritional intake in later life. Onset and progression of acute or chronic diseases and a reduced dietary intake play a crucial role in developing malnutrition. Malnutrition is associated with poor outcomes such as pressure injury, increased length of hospital stays and increased mortality. The aim of the chapter is to increase the nutritional-based knowledge of the interdisciplinary team to prevent malnutrition in all its forms. Therefore, this chapter offers evidence-based information to support interdisciplinary prevention of malnutrition in older adults across diverse healthcare settings.

Experience of Time and Subjective Age When Facing a Limited Lifetime: The Case of Older Adults with Advanced Cancer

2021 ◽  
pp. 089826432110631
Author(s):  
Katsiaryna Laryionava ◽  
Anton Schönstein ◽  
Pia Heußner ◽  
Wolfgang Hiddemann ◽  
Eva C. Winkler ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Advanced Cancer ◽  
Later Life ◽  
Subjective Age ◽  
Perceived Quality Of Life ◽  
Experience Of Time ◽  
Finite Resource ◽  
Life Threatening

Objectives We addressed two questions: (1) Does advanced cancer in later life affect a person’s awareness of time and their subjective age? (2) Are awareness of time and subjective age associated with distress, perceived quality of life, and depression? Methods We assessed patients suffering terminal cancer (OAC, n = 91) and older adults free of any life-threatening disease (OA, n = 89), all subjects being aged 50 years or older. Results Older adults with advanced cancer perceived time more strongly as being a finite resource and felt significantly older than OA controls. Feeling younger was meaningfully related with better quality of life and less distress. In the OA group, feeling younger was also associated to reduced depression. Perceiving time as a finite resource was related to higher quality of life in the OA group. Discussion Major indicators of an older person’s awareness of time and subjective aging differ between those being confronted with advanced cancer versus controls.

Caring for Older Adults During and After Critical Illness

2021 ◽  
pp. 216-234
Author(s):  
Maria C. Duggan ◽  
Julie Van ◽  
E. Wesley Ely
Keyword(s):  
Older Adults ◽  
Critical Illness ◽  
Health Care Professionals ◽  
Interdisciplinary Approach ◽  
Adverse Outcomes ◽  
Evidence Based ◽  
Complex Population ◽  
Multiple Domains ◽  
Over Time

Over half of people with critical illness are older adults, and the number of older adults admitted to intensive care units has been increasing over time. Older adults have increased vulnerability to disease, disability, and adverse outcomes across many domains. To address this most effectively, a unique, interdisciplinary approach is necessary to optimize not only survival but also functional status and quality of life. A shortage of health care professionals equipped to care for the aging population makes it imperative that all professionals become aware of basic principles of caring for older adults. To equip them to care for this complex population, this chapter provides an overview of how aging impacts multiple domains of an older person with critical illness and describes evidence-based approaches to caring for older adults with critical illness.

Preparing for an Epidemic: Cancer Care in an Aging Population

2014 ◽  
pp. 133-137 ◽  
Author(s):  
Ya-Chen Tina Shih ◽  
Arti Hurria
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Care Delivery ◽  
Quality Care ◽  
Aging Population ◽  
Population Based ◽  
Cancer Drug ◽  
Evidence Based ◽  
Evidence Based Care

The Institute of Medicine's (IOM) Committee on Improving the Quality of Cancer Care: Addressing the Challenges of an Aging Population was charged with evaluating and proposing recommendations on how to improve the quality of cancer care, with a specific focus on the aging population. Based on their findings, the IOM committee recently released a report highlighting their 10 recommendations for improving the quality of cancer care. Based on those recommendations, this article highlights ways to improve evidence-based care and addresses rising costs in health care for older adults with cancer. The IOM highlighted three recommendations to address the current research gaps in providing evidence-based care in older adults with cancer, which included (1) studying populations which match the age and health-risk profile of the population with the disease, (2) legislative incentives for companies to include patients that are older or with multiple morbidities in new cancer drug trials, and (3) expansion of research that contributes to the depth and breadth of data available for assessing interventions. The recommendations also highlighted the need to maintain affordable and accessible care for older adults with cancer, with an emphasis on finding creative solutions within both the care delivery system and payment models in order to balance costs while preserving quality of care. The implementation of the IOM's recommendations will be a key step in moving closer to the goal of providing accessible, affordable, evidence-based, high-quality care to all patients with cancer.

Substance Use in Later Life

2019 ◽  
Author(s):  
Stephen J. Bright
Keyword(s):  
Older Adults ◽  
Substance Use ◽  
Subjective Effects ◽  
Later Life ◽  
The United States ◽  
Primary Concern ◽  
Drinking Patterns ◽  
Medical Practitioners ◽  
Healthcare Settings ◽  
History Of

In the 21st century, we have seen a significant increase in the use of alcohol and other drugs (AODs) among older adults in most first world countries. In addition, people are living longer. Consequently, the number of older adults at risk of experiencing alcohol-related harm and substance use disorders (SUDs) is rising. Between 1992 and 2010, men in the United Kingdom aged 65 years or older had increased their drinking from an average 77.6 grams to 97.6 grams per week. Data from Australia show a 17% increase in risky drinking among those 60–69 between 2007 and 2016. Among Australians aged 60 or older, there was a 280% increase in recent cannabis use from 2001 to 2016. In the United States, rates of older people seeking treatment for cocaine, heroin, and methamphetamine have doubled in the past 10 years. This trend is expected to continue. Despite these alarming statistics, this population has been deemed “hidden,” as older adults often do not present to treatment with the SUD as a primary concern, and many healthcare professionals do not adequately screen for AOD use. With age, changes in physiology impact the way we metabolize alcohol and increase the subjective effects of alcohol. In addition, older adults are prone to increased use of medications and medical comorbidities. As such, drinking patterns that previously would have not been considered hazardous can become dangerous without any increase in alcohol consumption. This highlights the need for age-specific screening of all older patients within all healthcare settings. The etiology of AOD-related issues among older adults can be different from that of younger adults. For example, as a result of issues more common as one ages (e.g., loss and grief, identity crisis, and boredom), there is a distinct cohort of older adults who develop SUDs later in life despite no history of previous problematic AOD use. For some older adults who might have experimented with drugs in their youth, these age-specific issues precipitate the onset of a SUD. Meanwhile, there is a larger cohort of older adults with an extensive history of SUDs. Consequently, assessments need to be tailored to explore the issues that are unique to older adults who use AODs and can inform the development of age-specific formulations and treatment plans. In doing so, individualized treatments can be delivered to meet the needs of older adults. Such treatments must be tailored to address issues associated with aging (e.g., reduced mobility) and may require multidisciplinary input from medical practitioners and occupational therapists.

scholarly journals 471 - Online program to cope to prolonged grief: an end-user centered approach

2020 ◽  
Vol 32 (S1) ◽  
pp. 193-193
Author(s):  
J. Isaac ◽  
A. Gouveia ◽  
M. Suarez-Gomez ◽  
A. Rodrigues ◽  
R. Sousa ◽  
...  
Keyword(s):  
Older Adults ◽  
Assisted Living ◽  
Real Life ◽  
Later Life ◽  
Emotional Life ◽  
Prolonged Grief ◽  
Face To Face ◽  
Physical Problems ◽  
Psychiatric Department

Background: Loss of a spouse is a frequent occurrence in later life, with about 10% of the individuals finding themselves unable to cope and progressing to prolonged grief, risking further mental and physical problems.Objective: The development and implementation of an online grief program, such as LEAVES (optimizing the menta L hEalth and resilience of older Adults that haVe lost th Eir spou Se via blended, online therapy), intends to improve prevention and treatment of prolonged grief, so that elderly mourners can continue to lead an active, meaningful and dignified life.Methods: The LEAVES program, a project under AAL (Active and Assisted Living) 2019 Call for Sustainable Smart Solutions for Ageing Well, is in development by an international consortium and integrates academical, clinical and technical experts. The project will take place between February 2020 and January 2023 and involve real-life evaluation of 315 end-users. The Psychiatric Department at the Health Unit of Baixo Alentejo (ULSBA) will offer the service to its primary users, blending online services with telephone, video calls and face-to-face sessions. Widowed older adults >65 that express the need for help in mourning their spouse will be recruited in the community as well as via the geriatric psychiatry team and primary care.Results: With LEAVES program we aim for older adults to process the loss of a spouse in a blended online/presential environment, detecting olders at risk for complications, reveal negative trends in their emotional life, and act to counter such trends. The evaluation will focus on wellbeing and involve several measures to assess grief symptoms, loneliness, hopelessness, satisfaction and quality of life. Conclusions: ULSBA will use LEAVES to improve clinical practice on preventing and managing prolonged grief as well as, after testing and validating it in this project, to save economical costs and improve effectiveness, both to hospital and patients.

scholarly journals The Role and Impact of Radio Listening Practices in Older Adults’ Everyday Lives

2020 ◽  
Vol 11 ◽  
Author(s):  
Amanda E. Krause
Keyword(s):  
Older Adults ◽  
Low Cost ◽  
Leisure Activity ◽  
Later Life ◽  
Well Being ◽  
Younger Adults ◽  
Daily Lives ◽  
Space Model ◽  
Qualitative Thematic Analysis

Previous research has indicated older adults value listening to music as a leisure activity. Yet, recent research into listening practices broadly has often focused on younger adults and the use of newer, digital listening technologies. Nonetheless, the radio, which is familiar to older people who grew up with it at the forefront of family life, is important to consider with regard to listening practices and the potential associated well-being benefits. This research investigated older adults’ everyday radio listening practices, in order to begin to understand how the radio fits into their daily lives and how it might influence their sense of well-being. Twenty-five Australian residents (aged 66–87; 56% female, 44% male) participated in semi-structured, one-to-one interviews. The results of a qualitative thematic analysis revealed themes concerning listening preferences, listening routines, access, and motivations/outcomes. While personal preferences (concerning content, stations, and presenters) were diverse, individuals clearly communicated these as well as their established listening routines and habits. Listener motivations varied: some people focused on the enjoyment that listening to the radio creates while some noted benefits to their well-being, such as relaxation, modifying their mood, and feelings of comfort and community. Radio listening practices can be defined in terms of differing engagement styles, as characterized using continua ranging from passive to active, or focused, listening as well as generalized or specific listening. Based on participants’ experiences, a proposed engagement space model links how people engage with the radio to the possible outcomes mentioned. Importantly, benefits to well-being can result from varied engagement styles. The findings presented provide an in-depth understanding of how the radio fits into older adults’ everyday life, with implications for considering how the radio might be used as a widely accessed, low-cost tool for maintaining and enhancing quality of later life.

scholarly journals Delivering Interprofessional Education to Embed Interdisciplinary Collaboration in Effective Nutritional Care

2021 ◽  
pp. 159-169
Author(s):  
Julie Santy-Tomlinson ◽  
Celia V. Laur ◽  
Sumantra Ray
Keyword(s):  
Older Adults ◽  
Capacity Building ◽  
Interprofessional Education ◽  
Interdisciplinary Collaboration ◽  
Interdisciplinary Team ◽  
Evidence Based ◽  
Nutritional Care ◽  
Nutrition Care ◽  
Interdisciplinary Approaches

AbstractPrevious and forthcoming chapters describe how to improve nutrition care with an emphasis on interdisciplinary approaches. Developing and improving the skills and knowledge of the interdisciplinary team through interprofessional education are essential for embedding evidence-based, collaborative, nutritional care. This capacity building in turn supports delivery of effective nutritional care for older adults.

scholarly journals Screening Tool Identifies Older Adults With Cancer at Risk for Poor Outcomes

2020 ◽  
Vol 18 (3) ◽  
pp. 305-313 ◽  
Author(s):  
Ryan D. Nipp ◽  
Leah L. Thompson ◽  
Brandon Temel ◽  
Charn-Xin Fuh ◽  
Christine Server ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
At Risk ◽  
Overall Survival ◽  
Symptom Burden ◽  
Hazard Ratio ◽  
Screening Tools ◽  
Vulnerable Patients ◽  
Poor Outcomes

Background: Oncologists often struggle with managing the complex issues unique to older adults with cancer, and research is needed to identify patients at risk for poor outcomes. Methods: This study enrolled patients aged ≥70 years within 8 weeks of a diagnosis of incurable gastrointestinal cancer. Patient-reported surveys were used to assess vulnerability (Vulnerable Elders Survey [scores ≥3 indicate a positive screen for vulnerability]), quality of life (QoL; EORTC Quality of Life of Cancer Patients questionnaire [higher scores indicate better QoL]), and symptoms (Edmonton Symptom Assessment System [ESAS; higher scores indicate greater symptom burden] and Geriatric Depression Scale [higher scores indicate greater depression symptoms]). Unplanned hospital visits within 90 days of enrollment and overall survival were evaluated. We used regression models to examine associations among vulnerability, QoL, symptom burden, hospitalizations, and overall survival. Results: Of 132 patients approached, 102 (77.3%) were enrolled (mean [M] ± SD age, 77.25 ± 5.75 years). Nearly half (45.1%) screened positive for vulnerability, and these patients were older (M, 79.45 vs 75.44 years; P=.001) and had more comorbid conditions (M, 2.13 vs 1.34; P=.017) compared with nonvulnerable patients. Vulnerable patients reported worse QoL across all domains (global QoL: M, 53.26 vs 66.82; P=.041; physical QoL: M, 58.95 vs 88.24; P<.001; role QoL: M, 53.99 vs 82.12; P=.001; emotional QoL: M, 73.19 vs 85.76; P=.007; cognitive QoL: M, 79.35 vs 92.73; P=.011; social QoL: M, 59.42 vs 82.42; P<.001), higher symptom burden (ESAS total: M, 31.05 vs 15.00; P<.001), and worse depression score (M, 4.74 vs 2.25; P<.001). Vulnerable patients had a higher risk of unplanned hospitalizations (hazard ratio, 2.38; 95% CI, 1.08–5.27; P=.032) and worse overall survival (hazard ratio, 2.26; 95% CI, 1.14–4.48; P=.020). Conclusions: Older adults with cancer who screen positive as vulnerable experience a higher symptom burden, greater healthcare use, and worse survival. Screening tools to identify vulnerable patients should be integrated into practice to guide clinical care.

scholarly journals Evidence-Based Approaches to Suicide in Older Adults—Zero Suicide

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 625-625
Author(s):  
Luming Li
Keyword(s):  
Older Adults ◽  
Suicide Prevention ◽  
Implementation Strategies ◽  
Essential Elements ◽  
Clinical Settings ◽  
Evidence Based ◽  
Term Care ◽  
Future Directions ◽  
Healthcare Settings

Abstract This individual symposium abstract will focus on evidence-based approaches to suicide in older adults, with particular focus on the Zero Suicide Model. Zero Suicide Model is a framework that applies seven essential elements of suicide care (Lead, Train, Identify, Engage, Treat, Transition, Improve). The model provides a systematic approach for quality improvement for suicide prevention and offers implementation strategies for “real-world” clinical settings using the Assess, Intervene, and Monitor for Suicide Prevention (AIM-SP) program for suicide-safer care. The authors will describe implementation of Zero Suicide in general healthcare settings that care for older adults, including health systems and outpatient clinics. The authors will also describe the value of Zero Suicide other settings such as long-term care centers, where older adults are cared for. In addition, the authors will describe future directions for research in the Zero Suicide Model and additional opportunities in public policy for suicide prevention.

scholarly journals Evidence-Based Integrative Health Care to Promote Quality of Life in Older Adults With Cancer

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 609-610
Author(s):  
Robin Majeski ◽  
Delia Chiaramonte
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Health Care ◽  
Cancer Care ◽  
Symptom Burden ◽  
Integrative Approach ◽  
Evidence Based ◽  
Cancer Symptoms ◽  
Integrative Health

Abstract Cancer disproportionately affects older adults and presents significant challenges to patients’ quality of life. Use of complementary medicine is increasing among older adults with cancer and these modalities have the potential for both benefit and harm. Thus, it is important that health care professionals are knowledgeable about the evidence-supported benefits and risks of complementary and integrative health approaches in the care of older adults with cancer. Integrative cancer care provides a comprehensive approach to reducing symptom burden in patients suffering with cancer symptoms and side effects of cancer treatment. Symptoms such as pain, fatigue, nausea, sleep disturbance, mood disorder, perceived stress, and reduced quality of life are common in this population.This session will discuss an evidence-based integrative approach to cancer care which incorporates both pharmacologic and non-pharmacologic modalities to decrease symptom burden, enhance patient well-being, and improve quality of life. Non-pharmacologic modalities used in the integrative approach to care will be described and relevant evidence for risks, benefits and indications will be presented. Case studies will be discussed to demonstrate the integration of these techniques into conventional western medical treatment plans for older adults with cancer. Diversity and inclusion issues relevant to integrative medicine for underserved cancer patients will be addressed, as well as recommendations for future research to expand access of underserved populations to evidence-supported integrative cancer care. A resource list will be provided to participants.

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