scholarly journals A software to prevent delirium in hospitalised older adults: development and feasibility assessment

2020 ◽  
Vol 49 (2) ◽  
pp. 239-245 ◽  
Author(s):  
Evelyn A Alvarez ◽  
Maricel Garrido ◽  
Daniela P Ponce ◽  
Gaspar Pizarro ◽  
Andres A Córdova ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthcare Professionals ◽  
Randomised Clinical Trial ◽  
Cognitive Stimulation ◽  
Early Mobilisation ◽  
Pharmacological Interventions ◽  
Feasibility Assessment ◽  
Hospitalised Patients ◽  
Improve Access ◽  
Large Interaction

Abstract Background non-pharmacological interventions to prevent delirium are useful in hospitalised older adults. However, they are poorly implemented in clinical practice. We aimed to develop a software for bedside use by hospitalised older adults and to improve their access to these interventions. Methods a transdisciplinary team composed of healthcare professionals, designers, engineers and older adults participated in the development of the software. Scrum methodology was used to coordinate the work of the team, and the software was evaluated in a feasibility study. Results a software for touchscreen mobile devices that supports Android 5.0 or later was produced, including modules for time-spatial re-orientation, cognitive stimulation, early mobilisation, sensorial support use promotion, sleep hygiene and pain management optimisation. Horizontal disposition, use of colour contrast and large interaction areas were used to improve accessibility. The software’s usability and accessibility were evaluated in 34 older adults (average age 73.2 ± 9.1 years) showing that 91.1% of them got access to all the software functions without previous instructions. The clinical feasibility assessment showed that 83.3% of the 30 enrolled hospitalised patients (76 ± 8 years) completed the 5-day protocol of software usage during hospitalisation. Software use was associated with a decreased trend in delirium incidence of 5 of 32 (15.6%) at baseline to 2 of 30 (6.6%) after its implementation. Conclusion a highly accessible and implementable software, designed to improve access to non-pharmacological interventions to prevent delirium in hospitalised older adults, was developed. The effectiveness of the software will be evaluated in a randomised clinical trial.

Usability of a tablet computer designed for older adults: a qualitative approach based on an intra-hospital living-lab for healthcare (Preprint)

2020 ◽  
Author(s):  
Guillaume Sacco ◽  
Pauline Carliez ◽  
Frédéric Noublanche ◽  
Romain Simon ◽  
Anne Renaudin ◽  
...  
Keyword(s):  
Older Adults ◽  
Geriatric Patients ◽  
Healthcare Professionals ◽  
Cross Sectional Study ◽  
Satisfaction Score ◽  
Tablet Computer ◽  
Sectional Study ◽  
Cross Sectional ◽  
System Usability Scale ◽  
Perceived Usability

BACKGROUND Usability is the keystone in the evolution of tablet technology in healthcare. The Ardoiz® tablet has been designed with a simplified interface for older adults. OBJECTIVE To assess the perceived usability and satisfaction of the Ardoiz® tablet. METHODS We conducted a mixed methods with cross-sectional study using System Usability Scale (SUS), satisfaction score and workshops, including geriatric patients, healthcare professional and caregivers. RESULTS Between September 25, 2019 and March 11, 2020, 58 participants were included in a cross-sectional study (including 38 patients, mean ±SD 85±6 years, 66% women), 26 in workshops (including 5 patients, mean ±SD 86.4±2.9, 40% women). The SUS was 74±12/100, the satisfaction score was 2.8±0.9/4, with 59% of satisfied participants with the use of Ardoiz® pads. The intent to acquire remained low with 18% (n=6) of participants who would be interested in acquiring the tablet. This tablet computer seemed to be difficult to use by geriatric patients and healthcare professionals, mainly because of its complex homepage. Nevertheless, former caregivers and healthcare professionals thought that the tablet could be of great interest to hospitals for leisure and medical use. The main feedback in order to improve the tablet is to simplify the home page with fewer and more static icons (without switching). CONCLUSIONS Notwithstanding the usability of the tablet, the intent to acquire of Ardoiz® tablet remained low. The interface should be simplified for older adults in order to improve usability and adherence. CLINICALTRIAL NCT04091152

7 Exploring healthcare professionals’ attitudes to future care planning with older adults in hospital: qualitative research co-design through multi-professional patient and carer involvement

2018 ◽  
Vol 8 (3) ◽  
pp. 362.2-362
Author(s):  
Anna-Maria Bielinska ◽  
Stephanie Archer ◽  
Catherine Urch ◽  
Ara Darzi
Keyword(s):  
Older Adults ◽  
Decision Making ◽  
End Of Life Care ◽  
Healthcare Professionals ◽  
List Type ◽  
Care Planning ◽  
Life Care ◽  
Topic Guide ◽  
Future Care ◽  
Advance Care

IntroductionDespite evidence that advance care planning in older hospital inpatients improves the quality of end-of-life care (Detering 2010) future care planning (FCP) with older adults remains to be normalised in hospital culture. It is therefore crucial to understand the attitudes of healthcare professionals to FCP in older patients in the hospital setting. Co-design with patients carers and healthcare professionals can generate more detailed meaningful data through better conversations.AimsTo co-design a semi-structured interview (SSI) topic guide to explore healthcare professionals’ attitudes to FCP with older adults in hospital.MethodsA multi-professional research group including a panel of patient and carer representatives co-designed an in-depth topic guide for a SSI exploring healthcare professionals’ attitudes to FCP with older adults in hospital.ResultsThe co-designed topic guide encourages participants to explore personal and system-level factors that may influence attitudes to FCP and practice in hospital amongst healthcare staff. Co-designed topics for inclusion in the SSI schedule include:Potential differences between specialist and generalist approaches to FCPThe influence of perceived hierarchy and emergency–decision making ability in professionals on FCP discussionsThe relevance to transitions of careAttitudes to FCP beyond the biomedical paradigm including perceived well–being and psychosocial aspects of careDigital FCP tools including patient–led FCP.ConclusionCo-designing qualitative research with older people and multi-disciplinary professionals may narrow translational gaps in implementing FCP by setting joint research priorities. Data generated from a co-designed study may expand understanding of hospital-based anticipatory decision-making with older adults.Reference. Detering KM, Hancock AD, Reade MC, Silvester W. The impact of advance care planning on end of life care in elderly patients: randomised controlled trial. BMJ23 March 2010;340:c1345.

scholarly journals Sex in Late Life: Assessing Adults’ Expectations and the Role of Healthcare Professionals

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 313-313
Author(s):  
Jill Naar ◽  
Raven Weaver ◽  
Shelbie Turner
Keyword(s):  
Older Adults ◽  
Sexual Health ◽  
Health Behaviors ◽  
Healthcare Professionals ◽  
Late Life ◽  
Sexual History ◽  
Growth Curve Models ◽  
The Us ◽  
Sexual Health Behaviors ◽  
The Life Course

Abstract Sexual activity contributes to quality of life throughout the lifespan. However, stigma about sex in late life influences older adults’ perceptions and healthcare professionals’ perceptions of older adults’ sexual health/behaviors. Using a multi-methods approach, we examined attitudes and knowledge about sexual health/behaviors in late life. Using longitudinal data from the Midlife in the US Study (Wave 1-3; N=7049), we ran age-based growth curve models to analyze changes in levels of optimism about sex in their future. We also piloted a survey with healthcare professionals assessing attitudes, knowledge, and awareness of policy about sexual health/behaviors among older adults. Adults’ expectations became less optimistic with increased age (β = -0.1, SE = 0.003, p < .0001). Men were more optimistic than women at age 20 (p = 0.016), but men’s optimism decreased over the life course at a faster rate than did women’s (p < .0001), so that from ages 40-93, men were less optimistic than women. Among healthcare professionals (N=21), the majority indicated never or rarely asking their clients about sexual history or health/behaviors; however, they indicated some knowledge about issues relevant to older adults (e.g., safe-sex practices, sexual dysfunction). Few indicated awareness about policies related to sexual behavior among residents (i.e., issues of consent, STIs). Among adults, there is a need to address declining optimism for expectations about sex in late life. Health professionals are well-situated to raise awareness and normalize discussions about sexual health, thus countering negative stigma and contributing to increasing optimism for expectations to remain sexually active.

scholarly journals Older Adults’ Experiences of a Physical Activity and Sedentary Behaviour Intervention: A Nested Qualitative Study in the SITLESS Multi-Country Randomised Clinical Trial

2021 ◽  
Vol 18 (9) ◽  
pp. 4730
Author(s):  
Nicole Blackburn ◽  
Mathias Skjodt ◽  
Mark Tully ◽  
Ilona Mc Mullan ◽  
Maria Giné-Garriga ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Interaction ◽  
Qualitative Study ◽  
Management Strategies ◽  
Randomised Clinical Trial ◽  
Control Group ◽  
Individual Interviews ◽  
Perceived Effects ◽  
Qualitative Methodologies ◽  
Exercise Referral

Background: The SITLESS programme comprises exercise referral schemes and self-management strategies and has been evaluated in a trial in Denmark, Spain, Germany and Northern Ireland. The aim of this qualitative study was to understand the implementation and contextual aspects of the intervention in relation to the mechanisms of impact and to explore the perceived effects. Methods: Qualitative methodologies were nested in the SITLESS trial including 71 individual interviews and 12 focus groups targeting intervention and control group participants from postintervention to 18-month follow-up in all intervention sites based on a semi-structured topic guide. Results: Overarching themes were identified under the framework categories of context, implementation, mechanisms of impact and perceived effects. The findings highlight the perceived barriers and facilitators to older adults’ engagement in exercise referral schemes. Social interaction and enjoyment through the group-based programmes are key components to promote adherence and encourage the maintenance of targeted behaviours through peer support and connectedness. Exit strategies and signposting to relevant classes and facilities enabled the maintenance of positive lifestyle behaviours. Conclusions: When designing and implementing interventions, key components enhancing social interaction, enjoyment and continuity should be in place in order to successfully promote sustained behaviour change.

scholarly journals SOP: treatment of delirium

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Juraj Kukolja ◽  
Jens Kuhn
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Pharmacological Treatment ◽  
Heart Surgery ◽  
Standard Operating Procedure ◽  
Risk Behaviour ◽  
Severe Trauma ◽  
Pharmacological Interventions ◽  
Hospitalised Patients ◽  
High Risk Behaviour

Abstract Introduction Delirium is a frequent complication in hospitalised patients, often leading to difficulties in patient management and is associated with increased morbidity and mortality. Most patients in intensive care units develop delirium, however, it is also frequently observed in non-intensive care unit settings. Risk factors are, among others, older age, brain pathology, severe trauma, orthopaedic or heart surgery, metabolic or electrolyte dysregulations, infections and polypharmacy. The most important measures to prevent and treat delirium are recognition and removal of risk factors and causes. Although delirium is a very common and serious complication, evidence for pharmacological treatment is poor, and guidelines remain controversial. Accordingly, non-pharmacological treatments have gained increasing attention and should be applied. Based on current literature, guidelines and personal recommendations, we developed a standard operating procedure (SOP) encompassing non-pharmacological and pharmacological treatment of delirium. Comments In order to prevent delirium, risk factors should be identified and taken into account when planning the hospital stay and treatment. Prevention should include multimodal non-pharmacological interventions. The treatment of delirium should encompass the elimination of potential causes and non-pharmacological interventions. Pharmacological treatment should be used in a time-limited manner and in the lowest possible dose for the management of highly stressful symptoms or high-risk behaviour. Conclusion The SOP provides a pragmatic algorithm for the non-pharmacological and pharmacological treatment of delirium.

Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia

2012 ◽  
Vol 24 (6) ◽  
pp. 856-870 ◽  
Author(s):  
Claudia Cooper ◽  
Naaheed Mukadam ◽  
Cornelius Katona ◽  
Constantine G. Lyketsos ◽  
David Ames ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coping Strategy ◽  
Cognitive Stimulation ◽  
Care Homes ◽  
Improve Quality ◽  
Family Carer ◽  
Pharmacological Interventions ◽  
People With Dementia ◽  
At Home

ABSTRACTBackground: People with dementia report lower quality of life, but we know little about what interventions might improve it.Methods: We systematically reviewed 20 randomized controlled trials reporting the effectiveness of non-pharmacological interventions in improving quality of life or well-being of people with dementia meeting predetermined criteria. We rated study validity with a checklist. We contacted authors for additional data. We calculated standardized mean differences (SMD) and, for studies reporting similar interventions, pooled standardized effect sizes (SES).Results: Pooled analyses found that family carer coping strategy-based interventions (four studies, which did not individually achieve significance; n = 420; SES 0.24 (range 0.03–0.45)) and combined patient activity and family carer coping interventions (two studies, not individually significant; n = 191; SES 0.84 (range 0.54–1.14)) might improve quality of life. In one high-quality study, a care management system improved quality of life of people with dementia living at home. Group Cognitive Stimulation Therapy (GCST) improved quality of life of people with dementia in care homes.Conclusion: Preliminary evidence indicated that coping strategy-based family carer therapy with or without a patient activity intervention improved quality of life of people with dementia living at home. GCST was the only effective intervention in a higher quality trial for those in care homes, but we did not find such evidence in the community. Few studies explored whether effects continued after the intervention stopped. Future research should explore the longer-term impact of interventions on, and devise strategies to increase, life quality of people with dementia living in care homes or at home without a family carer.

scholarly journals The PACE Study: A randomised clinical trial of cognitive activity (CA) for older adults with mild cognitive impairment (MCI)

Trials ◽  
2009 ◽  
Vol 10 (1) ◽  
Author(s):  
Mandy R Vidovich ◽  
Nicola T Lautenschlager ◽  
Leon Flicker ◽  
Linda Clare ◽  
Osvaldo P Almeida
Keyword(s):  
Older Adults ◽  
Clinical Trial ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cognitive Activity ◽  
Randomised Clinical Trial

scholarly journals Practices of healthcare professionals from the perspective of older adults living with cancer

Rev Rene ◽  
2016 ◽  
Vol 17 (2) ◽  
pp. 301
Author(s):  
Lucimara Sonaglio Rocha ◽  
Margrid Beuter ◽  
Eliane Tatsch Neves ◽  
Juliane Elis Both ◽  
Miriam Da Silveira Perrando ◽  
...  
Keyword(s):  
Older Adults ◽  
Healthcare Professionals ◽  
Living With Cancer

scholarly journals In-Home Drug Storage by Older Adults

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Lori Suet Hang Lo ◽  
Linda Yin King Lee ◽  
Irene Yuen Fung Wong ◽  
Yuen Yan Lai ◽  
Hoi Tong Au ◽  
...  
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Older Adult ◽  
Healthcare Professionals ◽  
Compliance Rate ◽  
Cross Sectional ◽  
Drug Storage ◽  
Convenience Sampling ◽  
Storage Methods ◽  
Negative Health Outcomes

Globally, in-home drug-storage compliance is often unsatisfactory, especially among older adults, and can lead to negative health outcomes. This study used a cross-sectional and descriptive design to examine in-home drug-storage compliance among older adults. Convenience sampling was used to recruit 117 older adults in Hong Kong. An in-home drug-storage checklist was used to assess the in-home drug-storage environments (light, temperature, and humidity) and drug-storage methods (drug safety, packaging, information, and expiration) of each older adult. The findings showed that Hong Kong older adults’ overall compliance rate in drug storage was 87.25%, and their compliance rate for drug-storage methods (84.59%) was lower than that for drug-storage environments (97.02%). Older adults who were of advanced age, who were less educated or who lived alone demonstrated lower in-home drug-storage compliance. This indicates the need to revise existing health-education strategies to encourage in-home drug-storage compliance. Healthcare professionals should assess older adults’ drug-storage compliance to identify less compliant subgroups and deliver specific drug-storage support as required. Family members should also be involved in this process.

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