Diagnosing and Treating Depressions in Nursing Home Residents: Challenges for GPs

2006 ◽  
Vol 12 (3) ◽  
pp. 104 ◽  
Author(s):  
Stella Koritsas ◽  
Sandra Davidson ◽  
David Clarke ◽  
Daniel O'Connor
Keyword(s):  
General Practice ◽  
Nursing Home ◽  
Nursing Homes ◽  
Elderly People ◽  
General Practitioners ◽  
Continuity Of Care ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Medical Services ◽  
Nursing Home Staff

Depression is more common in elderly people residing in nursing homes than it is in people of the same age residing in the community. In Australia, general practitioners (GPs) are the primary providers of medical services to the elderly in nursing homes; however, they often under-diagnose and/or inadequately treat depression in this population. The difficulties experienced by GPs are confounded by the breakdown in the continuity of care that is evident when a patient is admitted into a nursing home, by inadequate communication between GPs and nursing home staff, and systems within the nursing home that are not conducive to general practice. This paper discusses the challenges GPs face in diagnosing and treating depression in nursing home residents, and provides suggestions for strategies that may overcome these challenges.

The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

2022 ◽  
Vol 8 (1) ◽  
pp. 51-66
Author(s):  
Vesna Žegarac Leskovar ◽  
Vanja Skalicky Klemenčič
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Older People ◽  
Architectural Design ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Evaluation Tool ◽  
Negative Effect ◽  
Disproportionate Number ◽  
Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

scholarly journals Monitoring the introduction of universal influenza vaccination for the elderly people in the Netherlands

1998 ◽  
Vol 3 (3) ◽  
pp. 32-32
Author(s):  
G. A. van Essen
Keyword(s):  
General Practice ◽  
Information Systems ◽  
The Netherlands ◽  
Influenza Vaccination ◽  
Elderly People ◽  
General Practitioners ◽  
The Elderly

For many years, influenza vaccination in the Netherlands has been administered by general practitioners (GPs), with whom every person is registered. Nine out of ten practices use one of six approved general practice information systems (GPIS). The exponen

scholarly journals Research on Acoustic Environment in the Building of Nursing Homes Based on Sound Preference of the Elderly People: A Case Study in Harbin, China

2021 ◽  
Vol 12 ◽  
Author(s):  
Peng Cui ◽  
Jun Zhang ◽  
Ting Ting Li
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Public Space ◽  
Elderly People ◽  
The Elderly ◽  
Sound Perception ◽  
Acoustic Environment ◽  
Health Care Center ◽  
Living Space ◽  
Income Status

Nursing homes are the facilities where the elderly conduct their daily activities. This may lead to a complicated acoustic environment which would potentially affect the ability of the elderly to function. In this study, the main indoor public space of a nursing home in Harbin was taken as the research object, and the methods of field observation, sound measurement, and questionnaire survey were used to explore the sound perception and preference of the elderly. The results revealed that in terms of the temporal and spatial distribution of sound pressure level (SPL), the unit living space had the highest SPL, which was above 60 dB (A). The reverberation time (RT) of the unit living space, medical and health care center corridor, was 2.15 and 2.13 s, respectively, at a frequency of 1,000 Hz, which was within the discomfort range. The results also revealed that an acoustic environment had a strong correlation with humidity and a weak correlation with temperature. However, no significant correlation could be assessed with a luminous environment. The elderly people were generally willing to accept the natural sound sources. The factors of gender and offspring numbers had no significant impact on the evaluation of acoustic environment comfort, whereas marriage and income status affected the comfort. This study may help improve the quality of life of the elderly in the nursing home and provide a reference for the construction and design of pension facilities.

scholarly journals Notification and Communication Technology: An Observational Study of Call Light Systems in Nursing Homes

2019 ◽  
Author(s):  
Haneen Ali ◽  
Huiyang Li
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Observational Study ◽  
Standard Procedure ◽  
The Elderly ◽  
Nursing Home Staff ◽  
Before And After ◽  
Long Time ◽  
To Come

Abstract Background and Objectives: The call light system is one of the major communication technologies that links the nursing home staff to the needs of the residents. By providing residents with the ability to request assistance, the system becomes an indispensable resource for patient-focused healthcare. However, there is little known about how the call light systems are being used in nursing homes and how the system contributes to the safety and the quality of care for seniors. Therefore, the aims of this study are to understand the nursing home staff experience while using the call light systems and to uncover the usability issues associated with the implemented systems. Method: A mix of 150 hours of hypothetic-deductive (unstructured) and 90 hours of standard-procedure (structured) observational study were conducted in four different nursing homes. The data collected includes insights into the nursing homes work system and the process of locating and responding to call lights. Results: The data shows that the highest alarm rate is before and after meal times. The nursing staff exceeded the allotted time set by administration 50% of the time. Additionally, the staff canceled 10% of the call lights and did not immediately assist residents due to high workloads. Further, the staff forgot to come back to assist residents over 3% of the time. Usability issues such as broken parts, lack of feedback, lack of prioritization, and low/no discriminability are contributing to the long response time. More than 8% of the time, residents notified the staff about call lights after they waited for a long time, as these residents were left unattended. Conclusion: Nursing homes that are still using old call light systems risk the continuation of usability issues that can affect performance of the staff and contribute to a decline in staff and resident outcomes. While the healthcare industry has been at the forefront of technological advancements and implementation, it is important to recognize the influence of technology in the quality of service delivery for the elderly population in nursing homes and to the nursing homes staff working conditions.

scholarly journals Reducing Antibiotic Prescriptions for Urinary Tract Infection in Nursing Homes Using a Complex Tailored Intervention Targeting Nursing Home Staff: Protocol for a Cluster Randomized Controlled Trial (Preprint)

2020 ◽  
Author(s):  
Sif Helene Arnold ◽  
Jette Nygaard Jensen ◽  
Marius Brostrøm Kousgaard ◽  
Volkert Siersma ◽  
Lars Bjerrum ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Prescription ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Cluster Randomized Controlled Trial ◽  
Nursing Home Staff ◽  
Randomized Controlled ◽  
Cluster Randomized

BACKGROUND Urinary tract infection (UTI) is the most common reason for antibiotic prescription in nursing homes. Overprescription causes antibiotic-related harms in those who are treated and others residing within the nursing home. The diagnostic process in nursing homes is complicated with both challenging issues related to the elderly population and the nursing home setting. A physician rarely visits a nursing home for suspected UTI. Consequently, the knowledge of UTI and communication skills of staff influence the diagnosis. OBJECTIVE The objective of this study is to describe a cluster randomized controlled trial with a tailored complex intervention for improving the knowledge of UTI and communication skills of nursing home staff in order to decrease the number of antibiotic prescriptions for UTI in nursing home residents, without changing hospitalization and mortality. METHODS The study describes an open-label cluster randomized controlled trial with two parallel groups and a 1:1 allocation ratio. Twenty-two eligible nursing homes are sampled from the Capital Region of Denmark, corresponding to 1274 nursing home residents. The intervention group receives a dialogue tool, and all nursing home staff attend a workshop on UTI. The main outcomes of the study are the antibiotic prescription rate for UTI, all-cause hospitalization, all-cause mortality, and suspected UTI during the trial period. RESULTS The trial ended in April 2019. Data have been collected and are being analyzed. We expect the results of the trial to be published in a peer-reviewed journal in the fall of 2020. CONCLUSIONS The greatest strengths of this study are the randomized design, tailored development of the intervention, and access to medical records. The potential limitations are the hierarchy in the prescription process, Hawthorne effect, and biased access to data on signs and symptoms through a UTI diary. The results of this trial could offer a strategy to overcome some of the challenges of increased antibiotic resistance and could have implications in terms of how to handle cases of suspected UTI. CLINICALTRIAL ClinicalTrials.gov NCT03715062; https://clinicaltrials.gov/ct2/show/NCT03715062 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17710

scholarly journals COVID Seroprevalence, Symptoms and Mortality During the First Wave of SARS-CoV-2 in Canada

2021 ◽  
Author(s):  
◽  
Prabhat Jha
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
High Sensitivity ◽  
High Specificity ◽  
The Elderly ◽  
Dried Blood Spots ◽  
Mortality Data ◽  
Infection Prevalence ◽  
Antibody Testing

Background: Efforts to stem the SARS-CoV-2 pandemic in Canada can benefit from direct understanding of the prevalence, infection fatality rates (IFRs), and information on asymptomatic infection. Methods: We surveyed a representative sample of 19,994 adult Canadians about COVID symptoms and analyzed IgG antibodies against SARS-CoV-2 from self-collected dried blood spots (DBS) in 8,967 adults. A sensitive and specific chemiluminescence ELISA detected IgG to the spike trimer. We compared seroprevalence to deaths to establish IFRs and used mortality data to estimate infection levels in nursing home residents. Results: The best estimate (high specificity) of adult seroprevalence nationally is 1.7%, but as high as 3.5% (high sensitivity) depending on assay cut-offs. The highest prevalence was in Ontario (2.4-3.9%) and in younger adults aged 18-39 years (2.5-4.4%). Based on mortality, we estimated 13-17% of nursing home residents became infected. The first viral wave infected 0.54-1.08 million adult Canadians, half of whom were <40 years old. The IFR outside nursing homes was 0.20-0.40%, but the COVID mortality rate in nursing home residents was >70 times higher than that in comparably-aged adults living in the community. Seropositivity correlated with COVID symptoms, particularly during March. Asymptomatic adults constituted about a quarter of definite seropositives, with a greater proportion in the elderly. Interpretation: Canada had relatively low infection prevalence and low IFRs in the community, but not in nursing homes, during the first viral wave. Self-collected DBS for antibody testing is a practicable strategy to monitor the ongoing second viral wave and, eventually, vaccine-induced immunity among Canadian adults.

scholarly journals Development of a Tailored, Complex Intervention for Clinical Reflection and Communication about Suspected Urinary Tract Infections in Nursing Home Residents

Antibiotics ◽  
2020 ◽  
Vol 9 (6) ◽  
pp. 360
Author(s):  
Sif H. Arnold ◽  
Julie A. Olesen ◽  
Jette N. Jensen ◽  
Lars Bjerrum ◽  
Anne Holm ◽  
...  
Keyword(s):  
General Practice ◽  
Nursing Home ◽  
Urinary Tract ◽  
Nursing Homes ◽  
Communication Skills ◽  
Urinary Tract Infections ◽  
Complex Intervention ◽  
Resistant Bacteria ◽  
Nursing Home Staff ◽  
Tract Infections

Background: Inappropriate antibiotic treatments for urinary tract infections (UTIs) in nursing homes cause the development of resistant bacteria. Nonspecific symptoms and asymptomatic bacteriuria are drivers of overtreatment. Nursing home staff provide general practice with information about ailing residents; therefore, their knowledge and communication skills influence prescribing. This paper describes the development of a tailored, complex intervention for a cluster-randomised trial that targets the knowledge of UTI and communication skills in nursing home staff to reduce antibiotic prescriptions. Methods: A dialogue tool was drafted, drawing on participatory observations in nursing homes, interviews with stakeholders, and a survey in general practice. The tool was tailored through a five-phase process that included stakeholders. Finally, the tool and a case-based educational session were tested in a pilot study. Results: The main barriers were that complex patients were evaluated by healthcare staff with limited knowledge about disease and clinical reasoning; findings reported to general practice were insignificant and included vague descriptions; there was evidence of previous opinion bias; nonspecific symptoms were interpreted as UTI; intuitive reasoning led to the inappropriate suspicion of UTI. Conclusion: Sustainable change in antibiotic-prescribing behaviour in nursing homes requires a change in nursing home staff’s beliefs about and management of UTIs.

scholarly journals Is there any correlation between Magnesium status and depression in elderly people? A descriptive-analytical study among Tehran-nursing home residents

2021 ◽  
Vol 12 (2) ◽  
pp. 632-639
Author(s):  
Lyly Nazemi ◽  
Ingmar Skoog ◽  
Ingvar Karlsson ◽  
Margda Waern ◽  
Agneta Yngve ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Elderly Population ◽  
Analytical Study ◽  
Depression Scale ◽  
Nursing Home Residents ◽  
Mini Nutritional Assessment ◽  
The Elderly ◽  
Flame Atomic Absorption ◽  
Significant Difference

Background: Very few studies have shown the possible relationship between magnesium (Mg) status and depression. In the present study, the intracellular Mg status of the elderly population living in nursing homes (NHs) was assessed to determine its relationship with depression. Methods: A descriptive-analytical study was conducted on the elderly population living in nursing homes (Tehran-Iran; 2010-2012). Participants' demographic and clinical characteristics were collected and recorded in a checklist. Evaluating the participants’ nutritional status, Mini Nutritional Assessment Method was implemented. Determining participant's depressive symptoms, 15-item Geriatric Depression Scale was used. Final scores were classified into4 categories not depressed, mild, moderate, and severe depression. Mg level in leukocytes was also measured by flame atomic absorption spectrometry. Results: Totally 113 elderly were included and only 9.8% of subjects were not depressed. About 21% of the subjects were well nourished. Of participants who suffered from heart disease, 80.2% were depressed (p=0.03). Regarding correlations between Mg status and depression, results showed no significant difference in Mg levels of two depressed and non-depressed participants (p=0.73). Conclusion: The results of the present study showed notable prevalence rates of depression and malnutrition among nursing home residents. It was also found that the relationship between intracellular Mg levels and depression was not significant. Further studies are needed to determine the major factors related to these preventable psychological and nutritional disorders among elderly NH residents.

Environmental satisfaction levels of the elderly individuals in nursing home gardens

2020 ◽  
pp. 1420326X2096772
Author(s):  
Emine Tarakci Eren ◽  
Tuğba Düzenli ◽  
Mustafa Var
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Correlation Analysis ◽  
Nursing Home Residents ◽  
The Elderly ◽  
Individual Characteristics ◽  
Home Gardens ◽  
Satisfaction Level ◽  
Psychosocial Needs ◽  
Elderly Individuals

The present study presents a three-step methodology to determine the environmental satisfaction levels of the elderly individuals in nursing home gardens. The first step comprised the selection of seven nursing homes in five provinces in the Eastern Black Sea region in Turkey. In the second step, 130 participants were selected among the residents of these seven nursing homes via random sampling. In the third step, the satisfaction level of the nursing home residents with the institution gardens was determined. A correlation analysis showed a positive relationship between the environmental and individual characteristics ( r =  0.554; p < 0.01). Simple regression analysis was conducted to determine the effect of environmental characteristics on the satisfaction of individual needs, after determining the direction and level of the relationship between the environmental and the individual characteristics via correlation analysis. The analysis indicated a significant relationship between the environmental and individual characteristics ( R = 0.610; R2 = 0.373; F = 75.991; p <0.001). In conclusion, increased level of satisfaction with the existing physical characteristics of the gardens resulted in an increased level in meeting the psychosocial needs of the elderly individuals, thus, the environmental satisfaction level of nursing home residents increased as well.

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