Diagnostic investigations for stroke in older people: A practical approach

2020 ◽  
pp. 65-84
Author(s):  
Senthil Raghunathan
Keyword(s):  
Older People ◽  
Brain Imaging ◽  
Clinical Examination ◽  
Practical Approach ◽  
Cardiac Monitoring ◽  
Older Person ◽  
Diagnostic Investigation ◽  
Comprehensive History ◽  
Diagnostic Investigations

‘Diagnostic investigations for stroke in older people: A practical approach’ examines in some detail the challenges of formulating a thorough and simultaneously pragmatic approach to investigating older people with stroke. Diagnostic investigation plays an important role along with a comprehensive history and thorough clinical examination in assessing severity, prognosis, and initiating appropriate management. This chapter describes emergency investigations, brain imaging, biochemical and haematological investigations, the importance of electrocardiography and prolonged cardiac monitoring (including evidence from recent trials), echocardiography, the role of vascular imaging including ultrasonography and angiography. It also discusses the importance of performing all the essential investigations and the evidence for investigating stroke in the frail older person.

Foot problems

2017 ◽  
pp. 585-590
Author(s):  
Hylton B. Menz
Keyword(s):  
Quality Of Life ◽  
Older People ◽  
Weight Bearing ◽  
Older Person ◽  
Vascular Disorders ◽  
Foot Problems ◽  
Detrimental Impact

Foot problems affect one in four people aged over 65 years and have a major detrimental impact on mobility and quality of life. With advancing age, the foot undergoes several cutaneous, vascular, neurological, and musculoskeletal changes, all of which may impair this important weight bearing function and predispose the older person to the development of foot symptoms. This chapter provides an overview of the prevalence and impact of foot problems in older people, and briefly discusses the management of common foot problems in older people including skin and nail disorders, vascular disorders, and structural deformities. The important role of footwear in the management of foot problems is also highlighted.

scholarly journals 10 Playing Our Part - Are The Occupational Therapists Completing A Comprehensive Geriatric Assessment?

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii17-iii65
Author(s):  
Paula Lavery ◽  
Sinéad O'Connor
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Best Practice ◽  
Occupational Therapists ◽  
Initial Assessment ◽  
Older Person ◽  
Retrospective Audit ◽  
Interdisciplinary Assessment

Abstract Background 10% of people over 65 years have frailty, rising to between a quarter and a half of those over 85. Comprehensive Geriatric Assessment (CGA) is the gold standard for the management of frailty in older people; it’s a process that involves a holistic, interdisciplinary assessment of the older person. Evidence shows that CGA is effective in improving outcomes for older people. The National Clinical Programme for the Older Person outlines the role of the occupational therapist in CGA. A clinical audit was completed to investigate whether the occupational therapists in the Medicine for the Older Person service are adhering to guidelines for CGA. Methods Following a literature review, a retrospective audit of occupational therapy (OT) initial assessments was completed using paper count method. Data pertinent to CGA OT assessment was collected. Audit results were presented to the OT team alongside a CGA education session. A re-audit was completed, using above methods. Results 10 inpatient initial assessment forms reviewed pre and post audit. Activities of Daily Living Assessment: Pre result: 60%  Post Result: 90% Home Environment: Pre: 80% Post: 100% Performance Components Assessment: Vision: Pre:  90%  Post: 100% Hearing: Pre: 80% Post: 100% Upper Limb: Pre: 70% Post: 100% Mood: Pre: 60% Post: 80% Cognition: Pre: 90% Post: 100% Sleep: Pre: 70% Post: 80% Social Assessment: Pre: 60% Post:90% Falls Assessment: Pre: 60% Post: 90% Drving: Pre: 60% Post: 90% Conclusion This audit identified that the occupational therapists in the medicine for the older person service were not CGA compliant. CGA training now forms an important part of our OT induction programme. We are now “playing our part” in CGA with improvements in all domains. CGA is now commonplace practice within our team, in line with international and national best practice guidance for management of frailty.

Cancer-related fatigue: mechanisms, assessment and treatment in older people

2011 ◽  
Vol 21 (3) ◽  
pp. 256-266 ◽  
Author(s):  
Ollie Minton ◽  
Patrick C Stone
Keyword(s):  
Older People ◽  
Cancer Patients ◽  
Advanced Disease ◽  
Older Person ◽  
Management Options ◽  
Cancer Related Fatigue ◽  
The Poor ◽  
Assessment And Treatment ◽  
Clinical Tools

SummaryCancer-related fatigue (CRF) is a debilitating symptom that affects the majority of cancer patients. It can occur at all stages of treatment, worsening in advanced disease. It can be especially troublesome in the older person. CRF is often under-recognized and insufficiently treated routinely. This review will discuss both the postulated mechanisms and clinical tools for identifying and monitoring CRF during cancer treatment. The role of drug treatment and exercise to manage CRF is also assessed. Further studies, particularly in older people, are required to improve the poor levels of evidence for current CRF management options.

What does client ‘engagement’ mean in aged care? An analysis of practice

2017 ◽  
Vol 38 (7) ◽  
pp. 1350-1376 ◽  
Author(s):  
ANDREA PETRIWSKYJ ◽  
ALEXANDRA GIBSON ◽  
GLENYS WEBBY
Keyword(s):  
Older People ◽  
Aged Care ◽  
Power Dynamics ◽  
Power Relationships ◽  
Perceived Effectiveness ◽  
Older Person ◽  
Client Engagement ◽  
Engagement Strategies ◽  
Connection Building

ABSTRACTClient engagement is an important part of contemporary aged care. However, the extent to which decisions are delegated to the older person, and the scope of issues about which decision making occurs, vary. The types of engagement that are offered to, and taken up by, aged-care clients have implications for the extent of power and influence older people hold. This paper reports on a qualitative study conducted in a large Australian service provider. It identifies the forms that client engagement takes in the aged-care context, the roles for staff and older people that are enacted through these activities, and the implications these have for power relationships and older people's influence. An inverse relationship was seen between the depth and scope of client influence, but a desire to address this suggested potential spaces for greater empowerment. A relationship was evident between the retention of control by staff and the perceived effectiveness of existing engagement strategies, highlighting the limitations of traditional power dynamics in engagement practice. An expanded model of engagement in aged care is proposed that recognises the foundational role of connection building as a facilitator of greater empowerment for older people. Implications for theory regarding engagement in aged care, and the practice of engagement in aged-care organisations, are discussed.

ON THE ROLE OF BIOMONITORING IN THE ASSESSMENT OF THE HEALTH OF THE POPULATION EXPOSED TO MERCURY

2017 ◽  
pp. 2-7
Author(s):  
L. V. Lukovnikova ◽  
G. I. Sidorin ◽  
L. A. Alikbaeva ◽  
A. V. Galochina
Keyword(s):  
High Risk ◽  
Biological Monitoring ◽  
Clinical Examination ◽  
Inorganic Compounds ◽  
Risk Groups ◽  
Comprehensive Approach ◽  
Chemical Monitoring ◽  
Environmental Objects

When examining the population exposed to organic and inorganic compounds of mercury, a comprehensive approach is proposed, including chemical monitoring of environmental objects, biological monitoring, clinical examination of persons exposed to mercury, identification of high-risk groups.

Designing for older people: But who is an older person?

2016 ◽  
Author(s):  
Raghavendra Reddy Gudur ◽  
◽  
Alethea Blackler ◽  
Vesna Popovic ◽  
Doug Mahar
Keyword(s):  
Older People ◽  
Older Person

Role of Rasayana in Geriatric Care - A Review

2016 ◽  
Vol 1 (1) ◽  
Author(s):  
Yagyik Mishra ◽  
Negalur Vijay ◽  
Thakor Krunal ◽  
Bhat Nagaraj ◽  
Shubhasri B.
Keyword(s):  
Older People ◽  
Old Age ◽  
Statistical Data ◽  
Geriatric Care ◽  
The Body ◽  
Psychological Improvement

The growth of any country or society depends on the number of youth dwelling in that country but according to recent statistical data we soon will have older people more than children and more people at extreme old age than ever before. The number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050. Geriatrics (Jarachikitsa) is the branch of medicine dealing exclusively with the problems of aging and the diseases of elderly. The term Rasayana (rejuvination) refers to nourishment or nutrition. Rasayana therapy act essentially on nutrition dynamics and rejuvenate the body on both physical and mental levels. The problems of health due to modernization can be solved by increasing resistance against diseases and psychological improvement by implementing Rasayana therapy. Aging (Jara) is one among the Swabhavika Vyadhis. Jara Chikitsa is one among the Astanga of Ayurveda which is specifically dedicated for geriatric care. As per estimation, India currently has around 75 million persons over 65 years. By proper administration of Rasayana therapy as preventive tool one can delay Jara Janita Vyadhis to occur. This paper highlights the role of Rasayana in geriatric care.

Prioritization and management of calls from older people to GP out-of-hours services

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Suzanne Smith ◽  
Lucia Carragher
Keyword(s):  
Older People ◽  
Service Provision ◽  
Emergency Services ◽  
Oldest Old ◽  
Community Dwelling ◽  
Third Party ◽  
Older Person ◽  
Out Of Hours ◽  
Accident And Emergency ◽  
Community Dwelling Older People

Abstract Background Urgent out-of-hours medical care is necessary to ensure people can remain living at home into older age. However, older people experience multiple barriers to using out-of-hours services including poor awareness about the general practitioner (GP) out-of-hours (GPOOH) service and how to access it. In particular, older people are reluctant users of GPOOH services because they expect either their symptoms will not be taken seriously or they will simply be referred to hospital accident and emergency services. The aim of this study was to examine if this expectation was borne out in the manner of GPOOH service provision. Objective The objective was to establish the urgency categorization and management of calls to GPOOH , for community dwelling older people in Ireland. Methods An 8-week sample of 770 calls, for people over 65 years, to a GPOOH service in Ireland, was analysed using Excel and Nvivo software. Results Urgency categorization of older people shows 40% of calls categorized as urgent. Recognition of the severity of symptoms, prompting calls to the GPOOH service, is also reflected in a quarter of callers receiving a home visit by the GP and referral of a third of calls to emergency services. The findings also show widespread reliance on another person to negotiate the GPOOH system, with a third party making 70% of calls on behalf of the older person seeking care. Conclusion Older people are in urgent need of medical services when they contact GPOOH service, which plays an effective and patient-centred gatekeeping role, particularly directing the oldest old to the appropriate level of care outside GP office hours. The promotion of GPOOH services should be enhanced to ensure older people understand their role in supporting community living.

Older people’s news dependency and social connectedness

2021 ◽  
pp. 1329878X2110064
Author(s):  
Caroline Fisher ◽  
Sora Park ◽  
Jee Young Lee ◽  
Kate Holland ◽  
Emma John
Keyword(s):  
Older People ◽  
Social Isolation ◽  
News Media ◽  
Digital Literacy ◽  
Social Connectedness ◽  
Aged Care ◽  
Capital City ◽  
Contributing Factors ◽  
Older Citizens

Social isolation has become a growing issue, particularly among older citizens. The ‘digital divide’ has been identified as one of the contributing factors leaving many older citizens behind. While increasing digital literacy among seniors has been identified as one of the remedies, less attention has been paid to the role of news media on the wellbeing and connectedness of older people. Through the lens of the uses and gratifications theory, this article reports on the findings of a survey of 562 news consumers aged 50 years and above who live in Canberra, the capital city of Australia. The analysis highlights the important role of news in reducing feelings of social isolation, particularly for those who spend more time alone and older people with cognitive impairment. Older participants who had difficulty concentrating and learning new tasks were also more dependent on news. We suggest this is due to the habitual, predictable and concise nature of news. These findings contribute to our understanding of the role of news in the wellbeing of older people and point to the need for policymakers and those in the aged care sector to ensure access to news for older citizens to improve the quality of life.

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