scholarly journals MP34: Elder abuse in the emergency department: a systematic scoping review

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S54-S55
Author(s):  
E. Mercier ◽  
A. Nadeau ◽  
A. Brousseau ◽  
M. Emond ◽  
J. Lowthian ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Emergency Department ◽  
Physical Abuse ◽  
Health Care Providers ◽  
Scoping Review ◽  
Elder Abuse ◽  
Community Dwelling ◽  
Screening Tools ◽  
Care Providers

Introduction: This systematic scoping review aims to synthetize the available evidence on the epidemiology, risk factors, clinical characteristics, screening tools, prevention strategies, interventions and knowledge of health care providers regarding elder abuse in the emergency department (ED). Methods: A systematic literature search was performed using three databases (Medline, Embase and Cochrane Library). Grey literature was scrutinized. Studies were considered eligible when they were observational studies or randomized control trials reporting on elder abuse in the prehospital and/or ED setting. Data extraction was performed independently by two researchers and a qualitative approach was used to synthetize the findings. Results: A total of 443 citations were retrieved from which 58 studies published between 1988 and 2018 were finally included. Prevalence of elder abuse following an ED visit varied between 0.01% and 0.03%. Reporting of elder abuse to proper law authorities by ED physicians varied between 2% to 50% of suspected cases. The most common reported type of elder abuse detected was neglect followed by physical abuse. Female gender was the most consistent factor associated with elder abuse. Cognitive impairment, behavioral problems and psychiatric disorder of the patient or the caregiver were also associated with physical abuse and neglect as well as more frequent ED consultations. Several screening tools have been proposed, but ED-based validation is lacking. Literature on prehospital- or ED-initiated prevention and interventions was scarce without any controlled trial. Health care providers were poorly trained to detect and care for older adults who are suspected of being a victim of elder abuse. Conclusion: Elder abuse in the ED is an understudied topic. It remains underrecognized and underreported with ED prevalence rates lower than those in community-dwelling older adults. Health care providers reported lacking appropriate training and knowledge with regards to elder abuse. Dedicated ED studies are required.

scholarly journals Home Health Registered Nurses’ Experiences With Financial Exploitation of Older Women With Cognitive Impairment

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 701-701
Author(s):  
Carol Rogers ◽  
Lisa DeSpain ◽  
Janet Wilson
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Cognitive Impairment ◽  
Health Care Providers ◽  
Home Health Care ◽  
Elder Abuse ◽  
Home Health ◽  
Care Providers ◽  
Financial Exploitation ◽  
Data Saturation

Abstract Older adults diagnosed with cognitive impairment (CI) who live at home are at high risk for FE due to dependence on caregivers and diminishing cognitive and financial capacities. Health care providers are mandated reporters for elder abuse, that includes financial exploitation (FE), one of the seven types of older adult maltreatments. Twenty Home Health Care Nurses (HHRN) of older adults in Oklahoma were interviewed to discover their understanding and experiences with FE. Transcripts were analyzed by conventional content analysis. Line-by-line codes were generated inductively and codes were grouped into categories and themes until data saturation was reached. Five themes emerged: Red Flags, Familiar Offenders, Dire Consequences, Barriers/Facilitators, Doing Better. Conclusions: HHRNs are an untapped resource to provide suggestions for improvements of FE detection/reporting of older adults with CI and to help formulate policies, procedures, strategies to improve coordination and communication among healthcare, law enforcement, and social service systems.

scholarly journals Psychometric Properties of the “Lasher and Faulkender Anxiety about Aging Scale” among Iranian older people

2020 ◽  
Author(s):  
Amir Pakpour ◽  
Shamsedin Namjoo ◽  
Khadijeh Sabahiazar ◽  
Mohammad Asghari Jafarabadi ◽  
Vijay Kumar r Chattu ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Psychometric Properties ◽  
Health Care Providers ◽  
Health Care Services ◽  
Factor Model ◽  
The Elderly ◽  
Community Dwelling ◽  
Care Providers ◽  
Factors Affecting

Abstract BackgroundAssessing anxiety in the elderly and the factors affecting this phenomenon will help the health care providers to provide appropriate and effective support and health care services for older adults. The aim of the present study was to assess the psychometric properties of the Aging Scale (AAS) among Persian speaking older adults.Method:A sample of 703 community-dwelling older adults was recruited for the study. A 'forward-backward' translation procedure was conducted to develop the Iranian version of the AAS. Confirmatory factor analysis (CFA) and Rasch model were then used for construct validity, and GHQ-12 and MSPSS were utilized for assessing concurrent validity of the AAS.ResultThe study participants included 416 (59.2%) men and 287 (40.8%) women with an average age of 69.4 years (SD D 8.11). Cronbach’s alpha for Fear of Old People, Psychological Concerns, Physical Appearance, Fear of Losses and the overall score was 0.881, 0.705, 0.748, 0.768 and 0.77, respectively. Applying CFA, it was found that the four original factors model was the best solution with 0.55 of the total variance. The result of the CFA indicated that this four-factor model had a good fit to the data. The results were then confirmed by Rasch analysis. Moreover, the AAS was significantly correlated with MSPSS (r=-0.395, p < 0.001) and GHQ_12 (r = 0.238, p < 0.001).ConclusionThe Persian version of the AAS was found to be valid and reliable for measuring anxiety of ageing among Persian speaking elderly populations.

Brief Intimate Partner Violence Perpetration Screening Tools: A Scoping Review

2019 ◽  
pp. 152483801988854 ◽  
Author(s):  
Maxine Davis ◽  
Diana M. Padilla-Medina
Keyword(s):  
Health Care ◽  
Intimate Partner Violence ◽  
Health Care Providers ◽  
Scoping Review ◽  
Partner Violence ◽  
Intimate Partner ◽  
Screening Tools ◽  
Care Providers ◽  
Measurement Tools ◽  
Ipv Perpetration

Recent research findings indicate that patients are willing to disclose their use of violence to health-care providers if asked. Health-care providers have a unique opportunity to screen their patients for intimate partner violence (IPV) perpetration; however, given the time constraints and limited personnel within medical offices and emergency-care facilities, instrument brevity is critically important. The development and evaluation of tools to screen for IPV perpetration in health-care settings, particularly brief instruments, is limited by the lack of adequate guidelines, clear institutional policies for screening, and reviews of the available literature. Given the need for validated measurement tools, we assessed the psychometric properties of measurement tools designed to quickly detect IPV perpetration by conducting a scoping review. Our search identified five measures meeting eligibility requirements. Inclusion criteria required that study information be published in a peer-reviewed journal, be published in English or Spanish languages, contain 10 or less items, report psychometric testing results, require no additional information, and be designed to detect IPV perpetration. We searched subject-specific databases and the bibliographies of relevant publications to identify studies. As part of appraising and synthesizing the evidence, we found most measures to have good reliability and validity. Most measures contained 2–5 items. Most studies were conducted in the United States and utilized an adequate sample size. There were considerable differences in how each of the measures determined a positive or negative screening. Gaps in the literature and areas for future research pertained to sample diversity, invariance testing, and practice guidelines for implementation.

scholarly journals Nurse Practitioners’ Experiences of Polypharmacy in Community-Dwelling Older Adults

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 207-207
Author(s):  
Christine Pariseault ◽  
Nancy Sharts-Hopko ◽  
Elizabeth Blunt
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Older Adult ◽  
Health Care Providers ◽  
Nurse Practitioners ◽  
Adult Population ◽  
Medication Management ◽  
Community Dwelling ◽  
Care Providers ◽  
Adequate Care

Abstract Numerous studies exist that define polypharmacy and its impact on health. Additionally, the literature is rich in studies documenting the benefits of care provided by nurse practitioners. A gap in research exists at the intersection of the value of nurse practitioners in caring for older adults and their management of polypharmacy. Coinciding with a growth of America’s older adult population and the need for adequate care, the purpose of this study was to explore the experiences of nurse practitioners caring for older adults experiencing polypharmacy. A qualitative descriptive study was conducted using a purposive sampling of nurse practitioners who care for older adults. Interviews were conducted and data was analyzed for themes. Four themes emerged: defining polypharmacy, communicating and collaborating, clinical judgement of nurse practitioners in relation to polypharmacy, and medication issues of older adults. Major themes emerged that depict the complexity of medication management in older adults as well as the important role of NPs in providing care to older adults. The significance of the study findings to future practice includes improving communication and collaboration of prescribing health care providers, better identification and management of polypharmacy, and improving the health care delivered to older adults. Safe and effective prescribing for older adults requires NPs consider the unique needs of each older adult while utilizing technology to support collaboration and decision making.

Malpractice & Negligence: Cal. Supreme Court Clarifies Negligence Provisions under State’s Elder Abuse Act

1999 ◽  
Vol 27 (2) ◽  
pp. 203-203
Author(s):  
Kendra Carlson
Keyword(s):  
Health Care ◽  
Supreme Court ◽  
Health Care Providers ◽  
Elder Abuse ◽  
Skilled Nursing Facility ◽  
Pressure Sores ◽  
Care Providers ◽  
Nursing Facility ◽  
Skilled Nursing ◽  
The Supreme Court

The Supreme Court of California held, in Delaney v. Baker, 82 Cal. Rptr. 2d 610 (1999), that the heightened remedies available under the Elder Abuse Act (Act), Cal. Welf. & Inst. Code, §§ 15657,15657.2 (West 1998), apply to health care providers who engage in reckless neglect of an elder adult. The court interpreted two sections of the Act: (1) section 15657, which provides for enhanced remedies for reckless neglect; and (2) section 15657.2, which limits recovery for actions based on “professional negligence.” The court held that reckless neglect is distinct from professional negligence and therefore the restrictions on remedies against health care providers for professional negligence are inapplicable.Kay Delaney sued Meadowood, a skilled nursing facility (SNF), after a resident, her mother, died. Evidence at trial indicated that Rose Wallien, the decedent, was left lying in her own urine and feces for extended periods of time and had stage I11 and IV pressure sores on her ankles, feet, and buttocks at the time of her death.

Interdisciplinary Therapy Assessments for the Older Adult

2012 ◽  
Vol 17 (1) ◽  
pp. 11-16
Author(s):  
Lynn Chatfield ◽  
Sandra Christos ◽  
Michael McGregor
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Standardized Testing ◽  
Health Care Providers ◽  
Outcome Measurement ◽  
Care Providers ◽  
Patient Centered ◽  
Screening Process ◽  
Evidenced Based ◽  
Changing Economy

In a changing economy and a changing industry, health care providers need to complete thorough, comprehensive, and efficient assessments that provide both an accurate depiction of the patient's deficits and a blueprint to the path of treatment for older adults. Through standardized testing and observations as well as the goals and evidenced-based treatment plans we have devised, health care providers can maximize outcomes and the functional levels of patients. In this article, we review an interdisciplinary assessment that involves speech-language pathology, occupational therapy, physical therapy, and respiratory therapy to work with older adults in health care settings. Using the approach, we will examine the benefits of collaboration between disciplines, an interdisciplinary screening process, and the importance of sharing information from comprehensive discipline-specific evaluations. We also will discuss the importance of having an understanding of the varied scopes of practice, the utilization of outcome measurement tools, and a patient-centered assessment approach to care.

PERIPHERAL BRAIN

1995 ◽  
Vol 16 (6) ◽  
pp. 229-238
Author(s):  
Jill M. Baren ◽  
James S. Seidel
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Health Care Providers ◽  
Cardiopulmonary Arrest ◽  
Pediatric Emergency ◽  
Care Providers ◽  
Loss Of Life ◽  
Policies And Procedures ◽  
Emergency Drugs ◽  
Emergency Equipment

This section of Pediatrics in Review is designed to be clipped or duplicated and filed in a handy place in the office, clinic, or emergency department, providing a convenient and concise reference. All offices in which children are examined should have pediatric emergency equipment, supplies, drugs, policies, and procedures. The equipment, supplies, and drugs kept in the office will depend on the spectrum of ill or injured children seen in the practice. However, a source of oxygen, basic resuscitation drugs (suited to the patient population and experience of the health-care providers), and a dosage chart or weight-based dosing tape (Figure 1) should be available in all offices. The following list of drugs is fairly comprehensive and is organized according to sign or symptom needing treatment. Health-care providers should become familiar with the information regarding specific drugs that they use commonly, eg, choose a short-acting benzodiazepine such as diazepam or lorazepam for treating status epilepticus. The intraosseous (IO) route of drug administration can be used for the majority of emergency drugs listed in the chart that suggest administration by the intramuscular (IM) or intravenous (IV) routes. The IO route is appropriate for children age 6 years and younger and should be reserved for those circumstances where failure to achieve vascular access might result in loss of life or limb (ie, anaphylaxis, cardiopulmonary arrest).

On the Margins of Death: A Scoping Review on Palliative Care and Schizophrenia

2018 ◽  
Vol 34 (1) ◽  
pp. 62-69 ◽  
Author(s):  
Erin Relyea ◽  
Brooke MacDonald ◽  
Christina Cattaruzza ◽  
Denise Marshall
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Access To Care ◽  
End Of Life ◽  
Health Care Providers ◽  
Scoping Review ◽  
End Of Life Care ◽  
Psychosocial Interventions ◽  
Life Care ◽  
Care Providers

Schizophrenia is a serious chronic mental illness that results in marginalization and stigma for sufferers. It is the seventh leading cause for disability worldwide. The symptoms of the illness, including hallucinations, delusions, and extremely disordered thinking and behavior, may also introduce barriers to accessing treatment, education, housing, and employment. Little is known about end-of-life care for individuals with schizophrenia. To address this gap, a scoping review was conducted to enhance understanding of hospice and palliative care for patients with schizophrenia. From this scoping review, 342 unique titles and abstracts were identified through a search of 20 databases, including 11 social science databases, 6 medical databases, and 3 gray literature databases. A total of 32 articles met the inclusion criteria and the following 4 themes were identified: Stigma affecting quality of care and access to care; Issues related to consent and capacity for the patient’s end-of-life care decisions and to appoint substitute decision makers; Best practices for psychosocial interventions, pharmacology, family and health-care collaborations, goals of care, setting, and smoking; and Barriers to care, including setting, communication, provider education, and access to care. The review suggests the importance of mandatory interdisciplinary training practices and policy standards outlining cooperative communication across health-care providers. It highlights gaps in evidence-based research on psychosocial interventions and collaborative frameworks to enable the provision of quality end-of-life care for individuals with schizophrenia.

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