Common geriatric emergencies

2017 ◽  
pp. 1081-1086
Author(s):  
Simon Conroy ◽  
Rosa McNamara
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Emergency Medicine ◽  
General Population ◽  
Older People ◽  
Discharge Planning ◽  
Population Ageing ◽  
Younger Adults ◽  
Current Trends ◽  
Geriatric Emergency Medicine

Older adults make up an increasing share of emergency department (ED) users, as the proportion of those aged 65 years and older increases in the general population. Older adults often have physical, physiological, psychological, and social considerations which demand a different approach to evaluation, management, and discharge planning compared to most younger adults using the ED. Older people are also more likely to have accumulated morbidity throughout their life course. Thus, a focus on geriatric emergency medicine has become an increasingly important as clinicians adapt to meet the challenges of population ageing. Here we outline the current trends in ED usage by older adults and give an overview of how care of older people is structured in emergency medicine.

scholarly journals AGE DIFFERENCES IN POLITICAL ENGAGEMENT: ROLE OF SELF-RELEVANCE

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S785-S785
Author(s):  
Tze Kiu Wong ◽  
Helene H Fung
Keyword(s):  
Older Adults ◽  
Collective Action ◽  
Older People ◽  
Age Differences ◽  
Political Behavior ◽  
Social Issues ◽  
Political Engagement ◽  
Political Discussion ◽  
Younger Adults

Abstract Previous studies usually found that older people are less politically engaged than younger adults, especially when considering political behavior other than voting. The current study extends the Selective Engagement hypothesis (Hess, 2014) to political engagement. 81 younger adults and 79 older adults rated 8 issues on self-relevance and their willingness to engage in political discussion, arguments and collective action on each issue. The predicted moderating effect of self-relevance was not found, but older people indeed are more willing to discuss (B = 0.07, p = 0.027) and argue with others on more self-relevant issues (B = 0.06, p = 0.031). Perceived cost of collective action was found to be a moderator, such that self-relevance was less important than other factors for high-cost actions (B = -0.016, p = 0.013). The current research sheds light on potential ways to increase older adults’ engagement in social issues.

Ageing in an aged society: experiences and attitudes of Catholic order members towards population ageing and older people

2013 ◽  
Vol 35 (1) ◽  
pp. 1-36 ◽  
Author(s):  
MARC LUY ◽  
PRISKA FLANDORFER ◽  
PAOLA DI GIULIO
Keyword(s):  
General Population ◽  
Older People ◽  
General Public ◽  
Positive Attitude ◽  
Multivariate Analyses ◽  
Population Ageing ◽  
Intergenerational Solidarity ◽  
Basic Pattern ◽  
Policy Makers ◽  
Aged Society

ABSTRACTPopulation ageing occurs in all industrialised societies and is the demographic phenomenon that currently gets the highest attention from scientists, policy makers and the general public. The main aim of this paper is to broaden our understanding of its societal consequences, such as ageism and intergenerational solidarity. Our study is based on the 2008 investigation of attitudes towards population ageing and older people in seven European countries of Schoenmaeckerset al.We replicate their analysis in a specific human subpopulation in which the process of population ageing started earlier and is much more advanced than in the general societies: the members of Catholic orders. The study compares the attitudes of 148 nuns and monks from three Bavarian monasteries to those of the western German general population using descriptive and multivariate analyses in the context of the debate around population ageing in Germany. We discuss the specific characteristics of order members that might influence their attitudes and also take a brief look at their views on possible political strategies to solve the problems connected with the demographic changes. Our results confirm the findings of Schoenmaeckerset al.and reveal that worldly and monastic populations show an identical basic pattern of a positive attitude towards older people while at the same time considering population ageing a worrisome development. However, order members evaluate older people's abilities and their role in society more positively. This result gives rise to the optimistic perspective that in an aged population the younger and older generations can build a well-functioning society.

Primary diagnoses and outcomes of emergency department visits in older people with dementia: a hospital-based retrospective study in Taiwan

2019 ◽  
Vol 32 (1) ◽  
pp. 97-104
Author(s):  
Pei-Chao Lin ◽  
Li-Chan Lin ◽  
Hsiu-Fen Hsieh ◽  
Yao-Mei Chen ◽  
Pi-Ling Chou ◽  
...  
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Retrospective Study ◽  
Older People ◽  
Hospital Admission ◽  
Emergency Department Visits ◽  
Urban Setting ◽  
Research Database ◽  
Patient Records ◽  
People With Dementia

ABSTRACTObjectives:The objectives of this study were to investigate the primary diagnoses and outcomes of emergency department visits in older people with dementia and to compare these parameters with those in older adults without dementia.Design and Setting:This hospital-based retrospective study retrieved patient records from a hospital research database, which included the outpatient and inpatient claims of two hospitals.Participants:The patient records were retrieved from the two hospitals in an urban setting. The inclusion criteria were all patients aged 65 and older who had attended the two hospitals as an outpatient or inpatient between January 1, 2009, and December 31, 2016. Patients with dementia were identified to have at least three reports of diagnostic codes, either during outpatient visits, during emergency department visits, or in hospitalized database records. The other patients were categorized as patients without dementia.Measurements:The primary diagnosis during the emergency department visit, cost of emergency department treatment, cost of hospital admission, length of hospital stay, and diagnosis of death were collected.Results:A total of 149,203 outpatients and inpatients aged 65 and older who were admitted to the two hospitals were retrieved. The rate of emergency department visits in patients with dementia (23.2%) was lower than that in those without dementia (48.6%). The most frequent primary reason for emergency department visits and the main cause of patient death was pneumonia. Patients with dementia in the emergency department had higher hospital admission rates and longer hospital stays; however, the cost of treatment did not show a significant difference between the two groups.Conclusions:Future large and prospective studies should explore the severity of disease in older people with dementia and compare results with older adults without dementia in the emergency department.

Abuse of people with dementia

2009 ◽  
Vol 19 (1) ◽  
pp. 35-43 ◽  
Author(s):  
Amber Selwood ◽  
Claudia Cooper
Keyword(s):  
Older Adults ◽  
General Population ◽  
Older People ◽  
Memory Impairment ◽  
Social Care ◽  
Care Recipient ◽  
People With Dementia ◽  
Health And Social Care ◽  
Vulnerable People ◽  
With Memory

SummaryPeople with dementia are particularly vulnerable to abuse. It is inherently difficult to study as it is a hidden offence, perpetrated against vulnerable people with memory impairment, by those on whom they depend. In the general population, 6% of older people have experienced abuse in the last month and this rises to approximately 25% in vulnerable populations such as people with dementia. We know that various factors in the carer and the care recipient can predispose to a higher rate of abuse and this knowledge can be harnessed to try and improve prevention. There are also valid and reliable scales available to help detect abuse in vulnerable older adults. All health and social care professionals have a responsibility to act on any suspicion or evidence of significant abuse or neglect in order to ensure that appropriate management is taken.

scholarly journals 152 Implementation of Older Persons Rapid Assessment Hub (OPRAH) in the Emergency Department (ED)

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Comfort Adedokun ◽  
Rosa McNamara ◽  
Nessa O’Herlihy
Keyword(s):  
Older Adults ◽  
Emergency Department ◽  
Older People ◽  
Rapid Assessment ◽  
Admission Rate ◽  
Clinical Decision ◽  
Admission Rates ◽  
Clinical Decision Unit ◽  
Medical Referral ◽  
The Impact

Abstract Background The Emergency Department (ED) is where most people, including older adults in crises, seek care. OPRAH was introduced in order to meet the needs of our changing population. The unit was developed out of existing resources within the ED and cohorts both older patients and staff to an area more suitable to carry out assessments. Methods We used a quality improvement framework to develop our service. OPRAH is led by an ED GEM (Geriatric Emergency Medicine) consultant, staffed using the existing ED team, housed within footprint of the ED as part of the Clinical Decision Unit (CDU) with the addition of an HCA (healthcare assistant) as required. To determine the impact of the service on admissions of older adults, we collated patient records prospectively. These were reviewed and coded by senior ED professionals blinded to outcomes, to determine medical-referral rate for admission in these cohort. Results In the first 3 weeks of implementation, 76 patients were assessed. Four were admitted and 2 transferred to other hospitals. Mean age was 83 years ranging 66-103 years with an average of 262 minutes in the ED prior to OPRAH admission. Blinded coders review determined 53 (76%) of these patients would have been referred for admission. The majority of the remainder would have completed their care in the ED, as they were not eligible for admission to CDU. Conclusion Introduction of OPRAH to the ED has improved access for older people to short-stay ED led care and reduced admission rates. We have identified a trend towards fewer episodes where care by in-house teams is completed within the ED. We are in an early phase of this project. Nonetheless, it is evident that by redesigning how we assess older people in the ED and using available outpatient resources, we could impact on admission rate and length of stay in the ED without compromising patient care. Implementation has increased the use of the integrated care team, hospital and community MDT (multidisciplinary team).

scholarly journals Age as an Element of Diversity: Intergenerational Discussion to Improve Age-Related Attitudes

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 532-532
Author(s):  
Lisa Wagner ◽  
Tana Luger
Keyword(s):  
Older Adults ◽  
Young People ◽  
Older People ◽  
Younger Adults ◽  
Educational Funding ◽  
Health Funding ◽  
Age Related ◽  
Generational Groups ◽  
Societal Problems ◽  
Over Time

Abstract All generations must work together solving societal problems, yet age-related stereotypes are used to divide generations. Age derogation motivates younger people to vote by creating fear of an older White voting generation (Dear young people, don’t vote; 2018), and to belittle older people (“Okay, Boomer…”). Demonizing older people creates prejudice within families asking that people target loved ones, for example, by pitting educational funding for young against health funding for older adults. Neither group wins when divisiveness occurs. Generation to Generation, an intergenerational course for older and younger adults, promotes intergenerational contact. Students discuss topical issues (e.g., racism) in multi-generational groups. Using pretest-posttest design, all students were invited to complete questionnaires at beginning and end of term. Younger adults reported significant increases in affection, comfort, kinship, engagement and enthusiasm for older adults, whereas older adults showed stability over time. Intergenerational discussion may facilitate improved connections between generations.

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