scholarly journals Mortality and Health Outcomes for Older Adults Screened by an Area Agency on Aging Over a 4.5-Year Period

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 710-711
Author(s):  
Amber Gum ◽  
Lawrence Schonfeld ◽  
Kevin Kip ◽  
Mary Goldsworthy ◽  
Jesse Bell ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Functional Decline ◽  
Assessment Process ◽  
Term Care ◽  
Central Florida ◽  
Wide Range ◽  
Using Data

Abstract Area Agencies on Aging (AAA) screen older adults and oversee delivery of a wide range of home- and community-based services (HCBS). We examined the assessment process, services, and mortality and health outcomes for older adults screened by an Area Agency on Aging in west-central Florida. Most were self/family referred (78.9%). Using data from July 2013-December 2018, 23,225 older adults were screened. Individuals had an average of 2.6 years follow-up in the dataset, during which time 63.6% received additional assessments: follow-up screening (50.6%), comprehensive assessment for enrollment in HCBS (35.7%), or assessments for congregate meals or other services (13.7%). Results revealed differences in mortality: 22.5% of clients receiving services died compared to 32.1% of clients prioritized as lower risk and on waiting lists for services. Long-term care placement and functional decline outcomes also will be reviewed, along with implications for service delivery and managing waitlists.

scholarly journals Frailty and hospitalization-associated disability after pneumonia: A prospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Chan Mi Park ◽  
Wonsock Kim ◽  
Hye Chang Rhim ◽  
Eun Sik Lee ◽  
Jong Hun Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Outcome ◽  
Long Term Care ◽  
Functional Decline ◽  
Tube Feeding ◽  
Term Care ◽  
Pneumonia Severity ◽  
Frailty Assessment ◽  
Nasogastric Tube Feeding

Abstract Background Pneumonia is a major cause of morbidity and mortality in older adults. The role of frailty assessment in older adults with pneumonia is not well defined. Our purpose of the study was to investigate 30-day clinical course and functional outcomes of pneumonia in older adults with different levels of frailty. Methods A prospective cohort was conducted at a university hospital in Seoul, Korea with 176 patients who were 65 years or older and hospitalized with pneumonia. A 50-item deficit-accumulation frailty index (FI) (range: 0–1; robust < 0.15, pre-frail 0.15–0.24, mild-to-moderately frail 0.25–0.44, and severely frail ≥ 0.45) and the pneumonia severity CURB-65 score (range: 0–5) were measured. Primary outcome was death or functional decline, defined as worsening dependencies in 21 daily activities and physical tasks in 30 days. Secondary outcomes were intensive care unit admission, psychoactive drug use, nasogastric tube feeding, prolonged hospitalization (length of stay > 15 days), and discharge to a long-term care institution. Results The population had a median age 79 (interquartile range, 75–84) years, 68 (38.6 %) female, and 45 (25.5 %) robust, 36 (47.4 %) pre-frail, 37 (21.0 %) mild-to-moderately frail, and 58 (33.0 %) severely frail patients. After adjusting for age, sex, and CURB-65, the risk of primary outcome for increasing frailty categories was 46.7 %, 61.1 %, 83.8 %, and 86.2 %, respectively (p = 0.014). The risk was higher in patients with frailty (FI ≥ 0.25) than without (FI < 0.25) among those with CURB-65 0–2 points (75 % vs. 52 %; p = 0.022) and among those with CURB-65 3–5 points (93 % vs. 65 %; p = 0.007). In addition, patients with greater frailty were more likely to require nasogastric tube feeding (robust vs. severe frailty: 13.9 % vs. 60.3 %) and prolonged hospitalization (18.2 % vs. 50.9 %) and discharge to a long-term care institution (4.4 % vs. 59.3 %) (p < 0.05 for all). Rates of intensive care unit admission and psychoactive drug use were similar. Conclusions Older adults with frailty experience high rates of death or functional decline in 30 days of pneumonia hospitalization, regardless of the pneumonia severity. These results underscore the importance of frailty assessment in the acute care setting.

scholarly journals The Impact of Function Focused Care From Acute Care to Home Care and Nursing Homes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 629-629
Author(s):  
Silke Metzelthin ◽  
Sandra Zwakhalen ◽  
Barbara Resnick
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Home Care ◽  
Acute Care ◽  
Long Term Care ◽  
Functional Decline ◽  
Term Care ◽  
The Us ◽  
The Impact

Abstract Functional decline in older adults often lead towards acute or long-term care. In practice, caregivers often focus on completion of care tasks and of prevention of injuries from falls. This task based, safety approach inadvertently results in fewer opportunities for older adults to be actively involved in activities. Further deconditioning and functional decline are common consequences of this inactivity. To prevent or postpone these consequences Function Focused Care (FFC) was developed meaning that caregivers adapt their level of assistance to the capabilities of older adults and stimulate them to do as much as possible by themselves. FFC was first implemented in institutionalized long-term care in the US, but has spread rapidly to other settings (e.g. acute care), target groups (e.g. people with dementia) and countries (e.g. the Netherlands). During this symposium, four presenters from the US and the Netherlands talk about the impact of FFC. The first presentation is about the results of a stepped wedge cluster trial showing a tendency to improve activities of daily living and mobility. The second presentation is about a FFC training program. FFC was feasible to implement in home care and professionals experienced positive changes in knowledge, attitude, skills and support. The next presenter reports about significant improvements regarding time spent in physical activity and a decrease in resistiveness to care in a cluster randomized controlled trial among nursing home residents with dementia. The fourth speaker presents the content and first results of a training program to implement FFC in nursing homes. Nursing Care of Older Adults Interest Group Sponsored Symposium

scholarly journals Association Between Urate-Lowering Therapies and Cognitive Decline in Community-Dwelling Older Adults: A Post-Hoc Analysis of the MAPT Study.

2021 ◽  
Author(s):  
Luc MOLET-BENHAMOU ◽  
Kelly VIRECOULON GIUDICI ◽  
Philipe BARRETO ◽  
Yves ROLLAND
Keyword(s):  
Older Adults ◽  
Cognitive Decline ◽  
Controlled Trial ◽  
Community Dwelling ◽  
Composite Score ◽  
Cognitive Score ◽  
Using Data ◽  
Community Dwelling Older Adults

Abstract Introduction Long-term use of urate-lowering therapies (ULT) may reduce inflammaging and thus prevent cognitive decline during aging. This article examined the association between long-term use of ULT and cognitive decline among community-dwelling older adults with spontaneous memory complaints. Material and methods We performed a secondary observational analysis using data of 1,673 participants ≥ 70 years old from the Multidomain Alzheimer Preventive Trial (MAPT Study), a randomized controlled trial assessing the effect of a multidomain intervention, the administration of polyunsaturated fatty acids (PUFA), both, or placebo on cognitive decline. We compared cognitive decline during the 5-year follow-up between three groups according to ULT use: participants treated with ULT during at least 75% of the study period (PT ≥ 75; n = 51), less than 75% (PT < 75; n = 31), and non-treated participants (PNT; n = 1,591). Cognitive function (measured by a composite score) was assessed at baseline, 6 months and every year for 5 years. Linear mixed models were performed and adjusted for age, sex, body mass index (BMI), diagnosis of arterial hypertension or diabetes, baseline composite cognitive score, and MAPT intervention groups. Results After the 5-year follow-up, only non-treated participants presented a significant decline in the cognitive composite score (mean change − 0.173, 95%CI -0.212 to -0.135; p < 0.0001). However, there were no differences in change of the composite cognitive score between groups (adjusted between-group difference for PNT vs. PT < 75: 0.089, 95%CI -0.160 to 0.338, p = 0.484; PNT vs. PT ≥ 75: 0.174, 95%CI -0.042 to 0.391, p = 0.115). Conclusion Use of ULT was not associated with reduced cognitive decline over a 5-year follow-up among community-dwelling older adults at risk of dementia.

scholarly journals Participation in Social Activities and Relationship between Walking Habits and Disability Incidence

2021 ◽  
Vol 10 (9) ◽  
pp. 1895
Author(s):  
Osamu Katayama ◽  
Sangyoon Lee ◽  
Seongryu Bae ◽  
Keitaro Makino ◽  
Ippei Chiba ◽  
...  
Keyword(s):  
Older Adults ◽  
Social Activity ◽  
Community Dwelling ◽  
Social Activities ◽  
Term Care ◽  
Long Term Care Insurance ◽  
Community Dwelling Older Adults ◽  
The Relationship

Identifying the relationship between physical and social activity and disability among community-dwelling older adults may provide important information for implementing tailored interventions to prevent disability progression. The aim of this study was to determine the effect of the number of social activities on the relationship between walking habits and disability incidence in older adults. We included 2873 older adults (mean age, 73.1 years; SD, ±5.9 years) from the National Center for Geriatrics and Gerontology—Study of Geriatric Syndromes. Baseline measurements, including frequencies of physical and social activities, health conditions, physical function, cognitive function, metabolic parameters, and other potential disability risk factors (for example, the number of years of education); monthly assessment for disability was monitored through long-term care insurance certification for at least 2 years from baseline. During a mean follow-up of 35.1 months (SD, 6.4 months), 133 participants developed disability. The disability incidence was 19.0 and 27.9 per 1000 person-years for participants who walked more (≥3 times per week) and less (≤3 times per week) frequently, respectively. The potential confounding factor-adjusted disability hazard ratio was 0.67 (95% confidence interval, 0.46 to 0.96; p = 0.030). The relationship between habitual walking and the number of social activities was statistically significant (p = 0.004). The reduction of disability risk by walking was greater among participants with fewer social activities. Habitual walking was associated with disability incidence, with a more pronounced effect among older adults who were less likely to engage in social activities.

scholarly journals Prevention of reducing functional decline in hospitalized older adults

2021 ◽  
pp. 357-362
Author(s):  
O. N. Tkacheva ◽  
N. K. Runikhina ◽  
Yu. V. Kotovskaya ◽  
N. V. Sharashkina
Keyword(s):  
Older Adults ◽  
Daily Activity ◽  
Long Term Care ◽  
Functional Decline ◽  
Older Patient ◽  
Term Care ◽  
Care Protocol ◽  
Hospitalized Older Adults

Preventing decreased physical and functional activity in older adults during hospitalization is a geriatric care protocol for nurses. The frailty and the formation of long-term care dependence is a stronger predictor of mortality and is more important for assessing the prognosis for the quality of life and surviving an older patient than even the presence of specific diseases and maintaining a baseline level of daily activity for the patient. Activities aimed at maintaining physical, cognitive, and social functioning (increasing physical activity, socialization, etc.) will help ensure an increase in the level of physical functioning and older patients' safety.

scholarly journals Gerontology and Nursing in the Emergency Department

2021 ◽  
Author(s):  
Gerard Charles ◽  
Sophia Lau Pei Wen ◽  
Muhammad Saifuddin Bin Supandi
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Health Outcomes ◽  
Healthcare Workers ◽  
Further Education ◽  
Care Process ◽  
Term Care ◽  
Ageing Society ◽  
Wide Range ◽  
The Future

Background: With a rapid rise in our older adult population globally and due to their multimorbidities, our older adults are more likely to engage in the services provided in the emergency department at a higher rate than younger adults. The current emergency service delivery model may be ineffective against such an ageing phenomenon. Research reports most older adults having one or more co-morbidities including functional decline, dementia, and frailty. Studies have shown that older adults have been undertriaged with physicians not being able to comprehend their complex needs related to their presenting complaints in the emergency department. Geriatric emergency departments have incepted worldwide to better manage this care deficiency in the rapidly ageing society around the world. Data Sources: A search of published literature from 2010-2020 using (keywords) as described below was undertaken of which, relevant literature were selected for an informed review. Implications for Nursing: Understanding geriatric emergencies can enable healthcare workers to reduce undertriaging and provide appropriate care that improves patient's health outcomes currently and in the future in the emergency department. Further education in gerontology can also be a platform for our nurses to enhance their care and thought process, likewise upskilling themselves for the future geriatric population seeking treatment. Older healthcare workers will also be able to enhance their current job scope before retirement. In-house teachings from trained gerontologists or certified programs can shed light on the special care needs of our senior citizens globally. Conclusion: With our rapidly increasing population, we can expect an influx of our older patients both from home and long-term care facilities to present to the emergency department with a wide range of geriatric emergencies. By being able to create a geriatric screening process and tailored care models, healthcare workers will be able to understand their care process and in turn, improve patients' health outcomes and provide a quicker transition of care.

scholarly journals Interventions against Social Isolation of Older Adults: A Systematic Review of Existing Literature and Interventions

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 82
Author(s):  
Jaya Manjunath ◽  
Nandita Manoj ◽  
Tania Alchalabi
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Social Isolation ◽  
Term Care ◽  
Effective Interventions ◽  
The Social ◽  
Follow Up Studies ◽  
Health Studies

Social isolation is widespread among older adults, especially those confined to living in nursing homes and long-term care facilities. We completed a systematic review evaluating the effectiveness of 20 interventions used to combat social isolation in older adults. A scoring mechanism based on the Joanna Briggs Appraisal Checklist was utilized to determine the quality of the studies. Searches were conducted in “MedLine”, “PubMed”, “PsycINFO” and “Aging and Mental Health”. Studies completed on group and person-centered interventions against social isolation were the highest quality as the social isolation experienced by older adults decreased after the intervention, and this effect continued in follow-up studies. Other interventions such as volunteering-based interventions also alleviated isolation; however, follow-up studies were not completed to determine long-term efficacy. Given the increase in social isolation faced by older persons during the pandemic, our review can be utilized to create effective interventions to reduce social isolation.

scholarly journals ANTICIPATED NEED FOR NURSING HOME PLACEMENT AMONG LESBIAN, GAY, BISEXUAL ADULTS AGES 50-64: FINDINGS FROM THE HRS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S158-S159
Author(s):  
Mekiayla Singleton ◽  
Zach Gassoumis ◽  
Susan Enguidanos
Keyword(s):  
Older Adults ◽  
Cultural Sensitivity ◽  
Structural Changes ◽  
Term Care ◽  
Using Data ◽  
Home Placement ◽  
Health Rating ◽  
The Impact

Abstract By 2030, the population of LGBTQ older adults is expected to exceed 6 million. Yet little is known about the expected use of nursing homes (NH) among LGBTQ older adults. Prior research has found NHs lack cultural sensitivity, and that LGBTQ NH residents are going “back into the closet” and not disclosing their sexual orientation due to discrimination and quality of care concerns. Using data from 2016 HRS, we describe bivariate differences between the LGB and heterosexual population, ages 50 to 64, and conduct a linear regression to determine the impact of LGB status on self-reported chance of moving to a NH in the future. Compared with the heterosexual population (n=4,049), these LGB adults (n=158) had a higher mean self-reported chance of moving to a NH (p&lt;.01), fewer children (p&lt;.01) and reported a slightly higher health rating (p&lt;.05). LGB adults ages 50-64 also were more likely to be unmarried (71%, p&lt; .001), white (59%, p&lt; .001) and have a college degree (51%, p&lt;.001). After controlling for sociodemographic variables, there were no significant differences between LGB and heterosexual adults’ self-reported chance of moving to a NH. Although anticipated chance of moving to a NH is no different for LGB adults ages 50-64 when controlling for their sociodemographic profiles, as a group they have a higher anticipated chance than heterosexual adults. These findings support the need for improved education, training, and structural changes within long-term care settings to better serve the growing older adult LGB population.

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