scholarly journals EDUCATIONAL INITIATIVE ABOUT MEDICATION MANAGEMENT FOR OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S35-S35
Author(s):  
Manpreet Boparai ◽  
Rosario Costas Muniz ◽  
Natalie Gangai ◽  
Ruth Manna ◽  
Beatriz Korc-Grodzicki
Keyword(s):  
Older Adults ◽  
South Asian ◽  
Health Care Providers ◽  
Medication Management ◽  
Asian Country ◽  
Community Dwelling ◽  
Care Providers ◽  
Loved One ◽  
The Us ◽  
Significant Change

Abstract Older adult patients often have multiple comorbidities, see multiple providers, leading to poor medication management (MM). Educational seminars were conducted to health care providers (HCPs) and community-based organizations to deliver health programs to linguistically diverse communities by a pharmacist utilizing interpreters. Participant knowledge was assessed using matched pre-post surveys (translated to participants’ respective languages). Behavioral intention was measured using a Likert scale. Results indicate participation from 136 community dwelling adults via 6 educational sessions; 44 caregivers via 5 sessions, and 22 HCPs (4 students and 22 residents) participated in one session. 91% of the community population were born outside of the US, 67% coming from South Asian countries, speaking over 7 different languages. Knowledge about medication management increased from an average of 44% correct responses pre-session to 48% correct post-session – a statistically significant change (t (135) =-2.26, p<.03). Most caregivers were females (82%) and born in a South Asian country (87%). Knowledge about medication management when caring for a loved one increased significantly from an average from pre (46%) to post (60%) (t (41) =-3.07, p< .01) Finally, most HCPs were females (53%), 63% Asian; 87% were born outside of the US, predominantly in East Asia. Providers had a significant increase on knowledge (t (21) =-3.03, p< .01) about prescribing for older adults. Detailed results of the programs will be presented. Despite challenges in diverse audience members, all three target populations indicated a statistically significant change in knowledge indicating the value in targeted and tailored health education topics.

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.

Improving Medication Management by Understanding Patient and Caregiver Preferences for Medication Packaging

2020 ◽  
Vol 35 (10) ◽  
pp. 446-464
Author(s):  
Joshua Chou ◽  
Merton Lee ◽  
Taylor Kaminsky ◽  
Tarlan Namvar ◽  
Catherine E. Cooke ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Providers ◽  
Health Care Professionals ◽  
Medication Management ◽  
The United States ◽  
Community Dwelling ◽  
Care Providers ◽  
Font Size ◽  
Visual Appearance ◽  
June July

OBJECTIVE: To assess older adults' perceptions and preferences when comparing multi-medication packaging products.<br/> DESIGN: Qualitative study involving focus group interviews (FGIs) and key informant interviews (KIIs).<br/> SETTING: Interviews were conducted in multiple cities within the United States during June-July 2019.<br/> PATIENTS, PARTICIPANTS: FGI participants (N=36) included community dwelling adults, 65 years of age or older, who took 5+ chronic medications, or their caregivers. KII participants (N=15) included health care professionals caring for similar populations.<br/> INTERVENTIONS: Participants were given samples of blister packs and pouches and asked about medication management and appearance and usability of medication packaging. Interviews were audio-recorded with participants' consent, then transcribed and coded using Atlas. ti. Recurrent and emergent themes were identified, and selected quotes served as examples of identified themes.<br/> MAIN OUTCOME MEASURE: Participants' perceptions regarding medication packaging.<br/> RESULTS: Participants' preferences varied for different multi-medication packaging systems. Similarly, most FGI participants did not communicate a strong attitude for or against their existing management systems. However, many FGI participants perceived a need for larger font size than seen on the either of the multimedication packaging samples. KII participants also preferred a larger font size on both packagings. KII participants thought the blister packs offered better visual organization and enabled caregivers to quickly assess adherence. However, KII participants expressed concern about integrating as-needed and short-term use medications and noted difficulty opening both types of packages.<br/> CONCLUSION: Visual appearance is important to both patients and health care providers. Continued research in this area is vital for tailoring packaging types and technology to patients.

scholarly journals A Pilot Study to Test the Feasibility of a Home Mobility Monitoring System in Community-Dwelling Older Adults

2019 ◽  
Vol 16 (9) ◽  
pp. 1512 ◽  
Author(s):  
Heesook Son ◽  
Hyerang Kim
Keyword(s):  
Older Adults ◽  
Monitoring System ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Care Providers ◽  
Remote Communication ◽  
Baseline Activity ◽  
Home Based ◽  
Health Related ◽  
Community Dwelling Older Adults

Technology enables home-based personalized care through continuous, automated, real-time monitoring of a participant’s health condition and remote communication between health care providers and participants. Technology has been implemented in a variety of nursing practices. However, little is known about the use of home mobility monitoring systems in visiting nursing practice. Therefore, the current study tested the feasibility of a home mobility monitoring system as a supportive tool for monitoring daily activities in community-dwelling older adults. Daily mobility data were collected for 15 months via home-based mobility monitoring sensors among eight older adults living alone. Indoor sensor outputs were categorized into sleeping, indoor activities, and going out. Atypical patterns were identified with reference to baseline activity. Daily indoor activities were clearly differentiated by sensor outputs and sensor outputs discriminated atypical activity patterns. During the year of monitoring, a health-related issue was identified in a participant. Our findings indicate the feasibility of a home mobility monitoring system for remote, continuous, and automated assessment of a participant’s health-related mobility patterns. Such a system could be used as a supportive tool to detect and intervene in the case of problematic health issues.

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.

Factors influencing older adults to complete advance directives

2010 ◽  
Vol 8 (3) ◽  
pp. 267-275 ◽  
Author(s):  
Gloria J. Alano ◽  
Renee Pekmezaris ◽  
Julia Y. Tai ◽  
Mohammed J. Hussain ◽  
Jose Jeune ◽  
...  
Keyword(s):  
Older Adults ◽  
New York ◽  
Health Care Providers ◽  
Female Gender ◽  
Community Dwelling ◽  
Major Surgery ◽  
Care Providers ◽  
Media Campaigns ◽  
Tertiary Teaching ◽  
Relief Of Suffering

AbstractObjective:The purpose of this study was to determine the factors which influence advance directive (AD) completion among older adults.Method:Direct interviews of hospitalized and community-dwelling cognitively intact patients >65 years of age were conducted in three tertiary teaching settings in New York. Analysis of AD completion focused on its correlation with demographics, personal beliefs, knowledge, attitudes, and exposure to educational media initiatives. We identified five variables with loadings of at least 0.30 in absolute value, along with five demographic variables (significant in the univariate analyses) for multiple logistic regression. The backward elimination method was used to select the final set of jointly significant predictor variables.Results:Of the 200 subjects consenting to an interview, 125 subjects (63%) had completed ADs. In comparing groups with and without ADs, gender (p < 0.0002), age (p < 0.0161), race (p < 0.0001), education (p < 0.0039), and religion (p < 0.0104) were significantly associated with having an AD. Factors predicting AD completion are: thinking an AD will help in the relief of suffering at the end of life, (OR 76.3,p < 0.0001), being asked to complete ADs/ or receiving explanation about ADs (OR 55.2,p < 0.0001), having undergone major surgery (OR 6.3,p < 0.0017), female gender (OR 11.1,p < 0.0001) and increasing age (76–85vs.59–75: OR 3.4,p < 0.0543; <85vs. 59–75: OR 6.3,p < 0.0263).Significance of results:This study suggests that among older adults, the probability of completing ADs is related to personal requests by health care providers, educational level, and exposure to advance care planning media campaigns.

Arthritis, Depression, and Falls Among Community-Dwelling Older Adults: Evidence From the Health and Retirement Study

2016 ◽  
Vol 37 (9) ◽  
pp. 1133-1149 ◽  
Author(s):  
Lien T. Quach ◽  
Jeffrey A. Burr
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Community Dwelling ◽  
Health And Retirement Study ◽  
Depression Symptoms ◽  
Care Providers ◽  
Significant Depression ◽  
Nationally Representative ◽  
Clinically Significant ◽  
Retirement Study

The aims of this study were to examine the association between different types of arthritis and falls and to investigate whether clinically significant depression symptoms (CSDS) moderate these relationships. The study used nationally representative data from the 2008 Health and Retirement Study ( n = 7,715, M age = 75, 62% female, and 90% White). Among the respondents, 42% experienced at least one fall during the previous 2 years. About one third had some form of arthritis: 22% osteoarthritis (OA), 4.8% rheumatoid arthritis (RA), 2.3% both OA and RA, and 7.9% with other arthritis types. About one fifth of respondents had CSDS. OA and CSDS are associated with the odds of falling (17% and 29%, respectively), adjusting for socio-demographic characteristics, lifestyle, health conditions, and psychiatric medications. There was no statistically significant interaction between types of arthritis and CSDS. Health care providers should pay attention to managing arthritis, especially OA, and CSDS to prevent falls among older adults.

scholarly journals Preparing for the New Normal: Chronicling the Impact of COVID-19 on Older Adults and Providers

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 585-585
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Justine Sefcik
Keyword(s):  
Older Adults ◽  
Health Care Providers ◽  
Healthcare Delivery ◽  
Community Dwelling ◽  
Retirement Community ◽  
Continuing Care ◽  
Care Providers ◽  
New Normal ◽  
Continuing Care Retirement Community ◽  
The Impact

Abstract COVID-19 and social distancing heralded an unprecedented change in the way older adults and health care providers live, work, socialize and manage their health. Early “calls-to-action” included the call for researchers to chronicle the impact of the COVID-19 pandemic on care of older adults to inform models of care and best practices in the new normal. This symposium explores the impact of COVID-19 on the health of older adults across the care continuum and healthcare delivery augmented by technology. The perspectives of older adults living in the community and providers who care for this population are highlighted. Additionally, there is a focus on the most vulnerable, those living in skilled care facilities and continuing care retirement communities. Fisher analyzes the key themes in 37 COVID-19 video communiques over 11 months at a continuing care retirement community. Sefcik explores coping strategies including outdoor activities among community-dwelling older adults. DiMaria-Ghalili examined patterns of physical and mental health, technology usage and loneliness in older adults, including those living in the community and a continuing care retirement community. Using longitudinal data and COVID-19 supplemental survey data from the National Health and Aging Trends Study, Huh-Yoo discusses disparities in online patient-provider communication and implications for the Post-COVID era. Coates discusses the facilitators and barriers perceived by interdisciplinary providers deploying telehealth during the COVID-19 pandemic and implications for healthcare delivery in older adults. The symposium will conclude with a discussion by Dr. Sefcik on the implications for research, practice and policy in the post COVID-19 era.

scholarly journals Integration of physical activity in reablement for community dwelling older adults: a systematic scoping review

2019 ◽  
Author(s):  
Hanne Leirbekk Mjøsund ◽  
Cathrine Fredriksen Moe ◽  
Elissa Burton ◽  
Lisbeth Uhrenfeldt
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Health Care Providers ◽  
Data Extraction ◽  
Community Dwelling ◽  
Cochrane Central Register ◽  
Care Providers ◽  
Limited Evidence ◽  
Individual Needs ◽  
Community Dwelling Older Adults

Abstract Introduction: Reablement is a rehabilitative intervention provided to homecare receivers (mostly older adults) with the aim of improving function and independence. There is limited evidence of the effectiveness of reablement and the content of these interventions is variable. Physical activity (PA) is known to be important for improving and maintaining function among older adults, but it is unclear how PA is integrated in reablement.Objective: To map existing evidence of how PA strategies are integrated and explored in studies of reablement for community dwelling older adults and to identify knowledge gaps.Methods: An apriori protocol was published. Studies investigating or exploring time-limited (within 6 months), interdisciplinary reablement for community-dwelling older adults, published in English, Norwegian, Danish, Swedish and German were considered for inclusion. PubMed, Cochrane central register of controlled trials, Embase, PsycINFO, AMED, PEDro, CINAHL and Google Scholar were searched for studies published between 1996 and July 2019, in addition to reference and citation searches. Study selection and data extraction were made independently by two reviewers.Results: Forty-three studies were included. Exercise strategies and practice of daily activities were reported to be included in the majority of intervention studies, but in most cases, no information was provided about the degree or intensity of which PA was involved, or how PA interventions were targeted to individual needs. Interventions aiming to increase general PA levels or reduce sedentary behavior were rarely described. None of the studies explored older adults’, health care providers’ or family members’ experiences with PA in a reablement setting, but some of the studies touched upon themes related to PA experiences. Some studies reported outcomes of physical fitness, including mobility, strength and balance, but there was insufficient evidence for any synthesis of these results. None of the studies reported PA levels among older adults receiving reablement.Conclusion: There is limited evidence regarding how PA is integrated in reablement, including how PA strategies are targeted to older adults’ individual needs and preferences in a reablement setting. The feasibility, and effectiveness of PA interventions, as well as experiences or barriers related to PA in a reablement setting should be further investigated.

scholarly journals Opportunities and Barriers to Medication Safety in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 611-612
Author(s):  
Fatoumata Jallow ◽  
Elisa Stehling ◽  
Zara Sajwani ◽  
Kathryn Daniel ◽  
Yan Xiao
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Safety ◽  
Medication Management ◽  
Primary Care Providers ◽  
Vulnerable Population ◽  
Community Dwelling ◽  
Care Providers ◽  
Essential Information ◽  
Barriers And Enablers

Abstract Community-dwelling multi-morbid older adults are a vulnerable population for medication safety-related threats. We interviewed a sample of these older adults recruited from local retirement communities and from primary care practices to learn their perceptions of barriers and enablers for their medication safety. The present study is part of the Partnership in Resilience for Medication Safety (PROMIS) study. One of the aims of this project is to identify barriers and opportunities to improve older adults' medication safety. These interviews were conducted during COVID-19 pandemic conditions. Results from this qualitative study suggest that trust between these older adults and their healthcare providers is an essential component of medication safety. Overarching themes include disruptions in medication management, caregivers caring for each other, patient safety practices or habits, and medication management literacy. Participants also shared strain due to lack of skills to navigate telemedicine visits, trust in Primary Care Providers (PCPs) and pharmacists to prescribe and dispense safely for them, reliance on PCPs and pharmacists to give essential information about medications without having to be asked. Our interviews illustrated large variations in older adults’ perceived role in medication safety, with some developing expertise in understanding how medications work for them and how long-term medications should be periodically reviewed. The types of information needs and supports from PCPs were likely different. Understanding these barriers and enablers for safe medication management can help us develop medication safety improvements for this vulnerable population.

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