scholarly journals Multidisciplinary Approach to Older Adults with Hematologic Malignancies—a Paradigm Shift

Author(s):  
Sarah A. Wall ◽  
Erin Stevens ◽  
Jennifer Vaughn ◽  
Naresh Bumma ◽  
Ashley E. Rosko ◽  
...  
2020 ◽  
Author(s):  
Weihong Kuang ◽  
Guojun Zeng ◽  
Yunbo Nie ◽  
Yan Cai ◽  
Jin Li ◽  
...  

UNSTRUCTURED The COVID-19 pandemic spurred unprecedented progress on a paradigm shift to telemedicine to limit exposure to the virus. Telemedicine has many benefits. In the West China Hospital of Sichuan University, we use it to do COVID-19 related tele-educations to health professionals and general population, tele-diagnosis, online treatment and internet-based drug prescription and delivery. However, at our practices, we are noticing that many older adults could not make appointment with doctors due to their difficulty using the internet-based platform. We worried that older adults who need healthcare the most are not well prepared for this rapid change. We need to pay attention to avoid causing treatment disparities for vulnerable older adults 60 years of age and over. Researchers and policy makers should work together to study effective strategies and make proper policies to mitigate barriers older adults face when using telemedicine.


2016 ◽  
Vol 138 (09) ◽  
pp. S8-S13 ◽  
Author(s):  
Thiago Marinho ◽  
Christopher Widdowson ◽  
Amy Oetting ◽  
Arun Lakshmanan ◽  
Hang Cui ◽  
...  

This article demonstrates a multidisciplinary approach that proposes to augment future caregiving by prolonged independence of older adults. The human–robot system allows the elderly to cooperate with small flying robots through an appropriate interface. ASPIRE provides a platform where high-level controllers can be designed to provide a layer of abstraction between the high-level task requests, the perceptual needs of the users, and the physical demands of the robotic platforms. With a robust framework that has the capability to account for human perception and comfort level, one can provide perceived safety for older adults, and further, add expressively that facilitates communication and interaction continuously throughout the stimulation. The proposed framework relies on an iterative process of low-level controllers design through experimental data collected from psychological trials. Future work includes the exploration of multiple carebots to cooperatively assist in caregiving tasks based on human-centered design approach.


Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 53-58 ◽  
Author(s):  
Heidi D. Klepin

Abstract Older adults represent the growing majority of patients diagnosed with hematologic disorders, yet they remain underrepresented on clinical trials. Older patients of the same chronologic age differ from one another with varying comorbidity and functional reserve. The concepts of frailty and resilience are important to patient-centered care and are patient and setting specific. The use of geriatric assessment to inform tailored decision making and management can personalize care for older adults with hematologic malignancies. This article will highlight available evidence to support the role of geriatric assessment measures to enhance quality of care for older adults diagnosed with hematologic malignancies.


2021 ◽  
Vol 11 ◽  
Author(s):  
Sarah A. Wall ◽  
Ying Huang ◽  
Ashleigh Keiter ◽  
Allesia Funderburg ◽  
Colin Kloock ◽  
...  

The incidence of hematologic malignancies (HMs) is highest in the seventh decade of life and coincides with increasing occult, age-related vulnerabilities. Identification of frailty is useful in prognostication and treatment decision-making for older adults with HMs. This real-world analysis describes 311 older adults with HMs evaluated in a multidisciplinary oncogeriatric clinic. The accumulation of geriatric conditions [1-unit increase, hazards ratio (HR) = 1.13, 95% CI 1.00–1.27, p = 0.04] and frailty assessed by the Rockwood Clinical Frailty Scale (CFS, mild/moderate/severe frailty vs. very fit/well, HR = 2.59, 95% CI 1.41–4.78, p = 0.002) were predictive of worse overall survival. In multivariate analysis, HM type [acute leukemia, HR = 3.84, 95% CI 1.60–9.22, p = 0.003; myelodysplastic syndrome (MDS)/myeloproliferative neoplasm (MPN)/bone marrow failure, HR = 2.65, 95% CI 1.10–6.35, p = 0.03], age (per 5-year increase, HR = 1.46, 95% CI 1.21–1.76, p < 0.001), hemoglobin (per 1 g/dl decrease, HR = 1.21, 95% CI 1.05–1.40, p = 0.009), deficit in activities of daily living (HR = 2.20, 95% CI 1.11–4.34, p = 0.02), and Mini Nutrition Assessment score (at-risk of malnutrition vs. normal, HR = 2.00, 95% CI 1.07–3.73, p = 0.03) were independently associated with risk of death. The most commonly prescribed geriatric interventions were in the domains of audiology (56%) and pharmacy (54%). The Rockwood CFS correlated with prescribed interventions in nutrition (p = 0.01) and physical function (p < 0.001) domains. Geriatric assessment with geriatric intervention can be practically integrated into the routine care of older adults with HMs.


Author(s):  
Heidi D. Klepin ◽  
David Rizzieri ◽  
Antonio Palumbo ◽  
Valeria Magarotto ◽  
Barbara Eichhorst

2018 ◽  
Vol 2 (suppl_1) ◽  
pp. 701-701
Author(s):  
C DuMontier ◽  
A Murillo ◽  
M Liu ◽  
T Hshieh ◽  
R Soiffer ◽  
...  

2021 ◽  
pp. 025371762110330
Author(s):  
Rakesh Chander Kalaivanan ◽  
Patley Rahul ◽  
Narayana Manjunatha ◽  
Channaveerachari Naveen Kumar ◽  
Palanimuthu Thangaraju Sivakumar ◽  
...  

Telemedicine has evolved as a novel tool in delivering health care in the modern world. With the advancement in video conferencing technology at an affordable price and innovative digital medical instruments, it has grown from guiding paramedics in managing patients to aiding physicians in providing direct consultation. Delivering care for older adults has always been challenging due to comorbidities that may warrant a multidisciplinary approach leading to frequent visits across specialties. As per the preliminary reports of the Longitudinal Aging Study in India, 55% of this population suffers from any chronic illness, of which 40% have some form of disability and 20% deal with mental health issues. Over the years, telepsychiatry care for older adults has received increasing acceptability. Videoconferencing with improved connectivity and transmission rates has aided in evaluating, assessing, and providing mental health interventions at ease. The recent regulation of telemedicine practice in the country by rolling out the Telemedicine Practice Guidelines 2020 and Telepsychiatry Operational Guidelines 2020 has fast-tracked its utility during the COVID-19 pandemic. Concerns of physical examination, psychological satisfaction of consulting physician in person, confidentiality, and security of information shared are points that need better addressing in the future. However, Telemedicine is recommended to be used judiciously, taking the risk and benefit of older adults on a case basis as it can significantly bring down the financial and emotional burden.


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