The South East Texas Geriatric Workforce Enhancement Program: Reach, Teach, Innovate

Abstract Through collaboration between academic and community partners, the South East Texas Geriatric Workforce Enhancement Program (SETx GWEP) aims to promulgate the 4Ms framework via a range of educational initiatives. The faculty and audience is interprofessional and diverse, representing the residents of South East Texas. Specific initiatives focus on Alzheimer’s disease and related dementias, elder abuse, geriatric mental health, patient priorities, transitions of care, and geriatric dental care. Training modalities include online modules, Project ECHO sessions, webinars, discussion forums, and simulation. During the COVID19 pandemic the SETx GWEP adapted to meet the needs of its stakeholders, including increasing the number of online activities, hosting town hall meetings, and developing training to address the impact of COVID19 on the older adult population. The SETxGWEP trained over 1000 people in 2020. To address healthcare disparities among older adults, SETx GWEP developed training on the practice of cultural humility in older adult care.

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Pressure injuries in the ageing population

Oxford Textbook of Geriatric Medicine ◽

10.1093/med/9780198701590.003.0053 ◽

2017 ◽

pp. 401-408

Author(s):

Cindy Kiely ◽

Magdalena Pupiales

Keyword(s):

Older Adult ◽

Pressure Ulcers ◽

Adult Population ◽

Incidence Rates ◽

Population Pressure ◽

Ageing Population ◽

Geriatric Population ◽

Bony Prominence ◽

Older Adult Population ◽

The Impact

The prevalence of pressure ulcers has been reported to range from 4.1 to 32.2% in the older adult population. Pressure ulcers, also known as decubitus ulcers, bedsores, and pressure sores, are defined as localized injury to the skin and/or underlying structures, usually over a bony prominence as result of pressure or pressure in combination with shear. Within the geriatric population, prevalence and incidence rates tend to be high due to multifactorial risk factors such as comorbidities, changes in functional status, nutritional habits, medications affecting the skin, and physiological changes. The impact of pressure ulcers spans physical, emotional, social, and economic dimensions, and is of concern throughout the healthcare continuum. The aim of this chapter is to illustrate the aetiologic complexity of pressure ulcers in the geriatric population and summarize a comprehensive approach to prevention and management of pressure ulcers.

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Current prevalence of dementia, depression and behavioural problems in the older adult care home sector: the South East London Care Home Survey

Age and Ageing ◽

10.1093/ageing/afu062 ◽

2014 ◽

Vol 43 (4) ◽

pp. 562-567 ◽

Cited By ~ 42

Author(s):

R. Stewart ◽

M. Hotopf ◽

M. Dewey ◽

C. Ballard ◽

J. Bisla ◽

...

Keyword(s):

Older Adult ◽

Care Home ◽

Behavioural Problems ◽

The South ◽

Adult Care ◽

Current Prevalence ◽

Prevalence Of Dementia

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A Cloud Infrastructure for Large Scale Health Monitoring in Older Adult Care Facilities

Innovation in Aging ◽

10.1093/geroni/igab046.3648 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 1029-1029

Author(s):

Yeonsik Noh ◽

Uchechukwu David

Keyword(s):

Nursing Homes ◽

Older Adult ◽

Large Scale ◽

Adult Population ◽

Raspberry Pi ◽

Cloud Infrastructure ◽

Adult Care ◽

Front End ◽

Time Operation ◽

Care Facilities

Abstract Technology development in the sub-field of older adult care has always been on the back-burner compared to other healthcare areas. But with increasing life expectancy, this is poised to change. With the increasing older adult population, the current older adult care facilities and personnel are struggling to keep up with demand. To address this matter, we proposed a distributed system infrastructure that will enable large-scale monitoring of vital signals and early detection of emergency situations in nursing homes and assisted living communities in this study. The system is mainly comprised of node devices and cloud infrastructure. The node device collects data from multiple users and forwards this data to the cloud service. Communication between the vital-sensing devices on the users and the node device is accomplished using Bluetooth Low-Energy (BLE). The Node device is implemented on a Raspberry Pi Model 3b+ which has built-in BLE capability. A cloud server consists of back-end and front-end components. The back-end handles all the data processing and logical decisions that drive the front-end. The front-end is the interface provided to the end-users, which can monitor all patients in nursing homes at the same time. We examined our system in terms of scalability, real-time operation, cost, and usability and then found that our system provides not only a smart remote monitoring solution that can provide a better aging experience for older adults and their families, but also increase automation in nursing homes leading to a reduction in running cost and an increase in capacity.

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Identifying roles in older adults’ emergency department transitions

Proceedings of the Human Factors and Ergonomics Society Annual Meeting ◽

10.1177/1071181320641159 ◽

2020 ◽

Vol 64 (1) ◽

pp. 685-689

Author(s):

Megan E. Salwei ◽

Hanna Barton ◽

Nicole E. Werner ◽

Rachel Rutkowski ◽

Peter L.T. Hoonakker ◽

...

Keyword(s):

Older Adults ◽

Emergency Department ◽

Older Adult ◽

Error Detection ◽

Care Transitions ◽

Care Facility ◽

Transitions Of Care ◽

Adult Care ◽

Term Care ◽

Long Term Care Facility

Older adults frequently visit the emergency department (ED) and participate in multiple transitions of care following an ED visit. These transitions of care, e.g. to hospital, long-term care facility or home, represent patient safety risks because of communication and coordination failures between the various roles involved, but also provide opportunities for error detection and recovery and, therefore, resilience. The objective of this study was to identify and describe the multiple roles involved in older adult care transitions during an ED visit. As part of a large research project, we conducted patient-centered observations and interviewed ED clinicians and hospital administrators. We identified 16 ED roles involved in older adult care transitions out of the ED, including 4 roles solely focused on coordinating transitions. By better understanding the roles involved in ED care transitions, we can improve the design of team processes and technologies to support care of older adults throughout their care transitions.

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In the Eye of the COVID-19 Storm: An Ethical Analysis on Aging, End of Life, and Recovery

Medical Research Archives ◽

10.18103/mra.v9i5.2414 ◽

2021 ◽

Vol 9 (5) ◽

Author(s):

Al Giwa

Keyword(s):

Older Adults ◽

Older Adult ◽

Elder Abuse ◽

Adult Population ◽

Severe Disease ◽

Multiple Chronic Conditions ◽

Geriatric Population ◽

Term Care ◽

Medical Response ◽

Older Adult Population

Early into the COVID pandemic, epidemiologists and infectious disease experts warned that older adults were among those most vulnerable to the disease, as multiple studies from China, Italy, Washington State, and New York City showed that age greater than 65 significantly increased the risk of severe disease and/or death from the novel 2019 coronavirus. Centers for Disease Control data through June 2020 show that nearly 81% of deaths due to COVID-19 are of people 65 years of age and older. These breakdowns indicate that, primarily, persons with advanced age and most, often, those with multiple chronic conditions are those who have died. The effects of the virus led to public health measures aimed at reducing exposures of older people and other vulnerable populations. The disease was amplified in rehabilitation centers, skilled nursing facilities, assisted living centers, group homes, and other long-term care facilities serving a primarily geriatric population. Even as parts of the country are opening up, the death toll is still climbing and affecting the older adult population disproportionately. Duty to care, autonomy and self-determination, non-judgmental regard, justice, and futility are all significant ethical principles and constructs that have arisen in the intense and real-time application of healthcare as we continue to face the present global pandemic. We use an ethical lens to examine the medical response of the SARS-CoV-2 pandemic on the older adult population and explore if society is doing enough to protect older adults, or rather, engaging in and furthering collective and systematic elder abuse.

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Social Isolation and COVID-19 Mitigation: Perspectives of Key Informants in the United States and Japan

Innovation in Aging ◽

10.1093/geroni/igab046.1705 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 441-441

Author(s):

Emily Ihara ◽

Megumi Inoue ◽

Cortney Hughes Rinker ◽

Naoru Koizumi

Keyword(s):

United States ◽

Older Adults ◽

Social Isolation ◽

Older Adult ◽

Adult Population ◽

The United States ◽

Mitigation Measures ◽

Adult Care ◽

Key Informant ◽

The Many

Abstract The deleterious health effects of social isolation and loneliness among older adults have been well-established and were exacerbated by the forced separation for those at health risk of contracting the COVID-19 virus. Both the United States and Japan are experiencing phenomenal growth of the older adult population; Japan is considered a “super-aged” society, with the highest proportion of people aged 65 and older in the world. This study examined how COVID-19 and mitigation measures may have affected services for older adults. We conducted key informant interviews with specialists in aging and older adult care in both Japan (n=5) and the United States (n=14). All interviews were conducted over Zoom and lasted 30-60 minutes. The research team transcribed and checked the interviews for accuracy and conducted multiple coding sessions to identify, sort, and consolidate the codes using Atlas.ti. Key themes in both countries that emerged included the many cracks in the system of programs and services for older adults, the inaccessibility to technology and the internet, and the particular difficulties of socioeconomic inequities, especially for those living alone. Older adults were motivated to become more technologically proficient and local communities came forward to help provide support. One key informant from the U.S. noted that their organization experienced a 600% increase in interest among volunteers as a result of the pandemic. Despite the many challenges of the pandemic, many silver linings emerged. One participant poetically stated, “I think that's human nature – when you have no other choice, you find a way.”

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The feasibility of an inter-professional transitions of care service in an older adult population

The American Journal of Emergency Medicine ◽

10.1016/j.ajem.2018.07.047 ◽

2019 ◽

Vol 37 (3) ◽

pp. 553-556

Author(s):

Lauren T. Southerland ◽

Brianne L. Porter ◽

Nicholas W. Newman ◽

Kimberly Payne ◽

Cara Hoyt ◽

...

Keyword(s):

Older Adult ◽

Care Service ◽

Adult Population ◽

Transitions Of Care ◽

Professional Transitions ◽

Older Adult Population

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CREATION OF EVIDENCE-BASED GERIATRIC SURGERY STANDARDS

Innovation in Aging ◽

10.1093/geroni/igz038.1485 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S400-S401

Author(s):

Marcia McGory Russell

Keyword(s):

Older Adults ◽

Older Adult ◽

Adult Population ◽

Acute Care Hospital ◽

Surgical Care ◽

Transitions Of Care ◽

Standards Of Care ◽

Care Hospital ◽

Geriatric Surgery ◽

High Quality

Abstract The aim of this abstract is to describe how to establish high-quality, valid standards to improve surgical care of the older adult. The older adult population has high demand for high-quality surgical care. Building upon prior guidelines, quality indicators, and pilot projects, the Coalition for Quality in Geriatric Surgery (CQGS) included 58 diverse stakeholder organizations committed to improving surgery for older adults. Using a modified RAND-UCLA Appropriateness Methodology, 44 of 58 CQGS Stakeholders twice rated validity (primary outcome) and feasibility for 308 standards, ranging from goals and decision-making, pre-operative assessment and optimization, perioperative and postoperative care, to transitions of care beyond the acute care hospital. Stakeholders rated the vast majority of standards of care as highly valid (99%) and feasible (94%) for improving the quality of surgical care provided to older adults.

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Improving older adults’ vaccination uptake: are existing measures of vaccine hesitancy valid and reliable for older people?

10.1101/2021.09.29.21263161 ◽

2021 ◽

Author(s):

Nicola Cogan ◽

Allyson J. Gallant ◽

Louise A. Brown Nicholls ◽

Susan Rasmussen ◽

David Young ◽

...

Keyword(s):

Older Adults ◽

Older Adult ◽

Discriminant Validity ◽

Adult Population ◽

Vaccine Uptake ◽

Vaccine Hesitancy ◽

Future Research ◽

Vaccination Uptake ◽

Older Adult Population ◽

The Impact

ABSTRACTOlder adults are particularly vulnerable to vaccine-preventable diseases (VDU), due to decreased immunity and increased comorbidity. Vaccination can support healthy ageing and help reduce morbidity, mortality, and loss of quality of life associated with VPDs. Despite the availability of effective vaccines, many countries, including the UK, fail to reach recommended coverage levels. Psychosocial factors are recognised as providing important insights into the determinants of vaccination uptake. Little research has sought to establish psychometrically sound scales of vaccine attitudes with older adults. In the present study, a total of 372 UK-based participants (65-92 years, M = 70.5 yrs, SD = 4.6) completed a cross-sectional, online survey measuring health and socio-demographic characteristics in relation to vaccination uptake for influenza, pneumococcal and shingles. Two recently developed vaccination attitude scales, the 5C scale and the Vaccination Attitudes Examination (VAX) scale, were also administered to test their reliability and validity for use with an older adult population. Additional scales used to examine convergent and discriminant validity, the Beliefs about Medicines Questionnaire, the Perceived Sensitivity to Medicines Scale, the Medical Mistrust Index, the Perceived Stress Scale, and the Interpersonal Support Evaluation List, were included. The factor structure of the 5C and VAX scales was confirmed. Both scales showed good internal reliability, convergent, discriminant and concurrent validity, supporting their use with older adult populations. The 5C and VAX scales were found to be reliable and valid psychosocial measures of vaccine hesitancy and acceptance within a UK-based, older adult population. Future research could use these scales to evaluate the impact of psychological antecedents of vaccine uptake, and how concerns about vaccination may be understood and addressed among older adults.Ethics approval & informed consentEthical approval (34/26/11/2019/Staff Williams) was granted by the School of Psychological Sciences and Health Ethics Committee, University of Strathclyde. (SEC19/20: Williams, Nicholls, Rasmussen, Young & Gallant). Approved on 8th January 2020.

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