Geriatrics

2014 ◽  
pp. 1065-1075
Author(s):  
Mark J. Simone ◽  
Suzanne E. Salamon
Keyword(s):  
Internal Medicine ◽  
Health Care Providers ◽  
Baby Boom ◽  
Geriatric Medicine ◽  
Geriatric Syndromes ◽  
Elderly Adults ◽  
Care Providers ◽  
Late Life Depression ◽  
Baby Boom Generation ◽  
Unique Approach

Geriatric medicine is the subspecialty of internal medicine that focuses on the care of patients over the age of 65. As life expectancy increases and the baby boom generation reaches old age, there will be a significant increase in this population. As of 2000 there were 35 million people 65 and older. This number is expected to double to over 70 million by 2030. The 85+ population is projected to increase from 4.2 million in 2000 to 7.3 million in 2020. There will never be enough geriatric specialists to care for this group of patients, so all health care providers must be aware of the key principles of geriatrics. The effects of normal aging and disease-related changes common in older adults necessitate a unique approach to caring for this group. There are several geriatric syndromes encountered regularly in elderly adults. These include polypharmacy, dementia, delirium, late-life depression, urinary incontinence, and falls.

How to Help Depressed Older People Living in Residential Care: A Multifaceted Shared-Care Intervention for Late-Life Depression

2001 ◽  
Vol 13 (4) ◽  
pp. 477-492 ◽  
Author(s):  
Robert H. Llewellyn-Jones ◽  
Karen A. Baikie ◽  
Sally Castell ◽  
Carol L. Andrews ◽  
Anne Baikie ◽  
...  
Keyword(s):  
Health Care ◽  
Residential Care ◽  
Health Care Providers ◽  
Assisted Living ◽  
Primary Care Physicians ◽  
Late Life ◽  
Shared Care ◽  
Care Providers ◽  
Late Life Depression ◽  
Care Intervention

Objective: To describe a population-based, multifaceted shared-care intervention for late-life depression in residential care as a new model of geriatric practice, to outline its development and implementation, and to describe the lessons learned during the implementation process. Setting: A large continuing-care retirement community in Sydney, Australia, providing three levels of care (independent living units, assisted-living complexes, and nursing homes). Participants:) The intervention was implemented for the entire non-nursing home population (residents in independent and assisted living: N = 1,466) of the facility and their health care providers. Of the 1,036 residents who were eligible and agreed to be interviewed, 281 (27.1%) were classified as depressed according to the Geriatric Depression Scale. Intervention Description: The intervention included: (a) multidisciplinary collaboration between primary care physicians, facility health care providers, and the local psychogeriatric service; (b) trainning for primary care physicians and other facility health care providers about detecting and managing depression; and (c) depression-related health education/promotion programs for residents. Conclusions: The intervention was widely accepted by residents and their health care providers, and was sustained and enhanced by the facility after the completion of the study. It is possible to implement and sustain a multifaceted shared-care intervention for late-life depression in a residential care facility where local psychogeriatric services are scarce, staff-to-resident ratios are low, and the needs of depressed to residents are substantial.

scholarly journals Physician Deaths from Corona Virus Disease (COVID-19)

2020 ◽  
Author(s):  
Edsel B. Ing ◽  
Alis (Qinyuan) Xu ◽  
Ali Salimi ◽  
Nurhan Torun
Keyword(s):  
Internal Medicine ◽  
Health Care Providers ◽  
Virus Disease ◽  
Protective Equipment ◽  
Care Providers ◽  
Front Line ◽  
Common Cause ◽  
Future Events ◽  
Infectious Disease Specialists ◽  
Line Work

ABSTRACTOBJECTIVEThe COVID-19 pandemic has caused much morbidity and mortality to patients but also health care providers. We tabulated the cases of physician deaths from COVID-19 associated with front-line work in hopes of mitigating future events.METHODOn April 5, 2020, Google internet search was performed using the keywords “doctor” “physician” “death” “COVID” “COVID-19” and “coronavirus” in English and Farsi, and in Chinese using the Baidu search engine.RESULTSWe found 198 physician deaths from COVID-19, but complete details were missing for 49 individuals. The average age of the physicians that died was 63.4 years (range 28 to 90 years) and the median age was 66 years of age. Ninety percent of the deceased physicians were male (175/194). General practitioners and emergency room doctors (78/192), respirologists (5/192), internal medicine specialists (11/192) and anesthesiologists (6/192) comprised 52% of those dying. Two percent of the deceased were epidemiologists (4/192), 2% were infectious disease specialists (4/192), 5% were dentists (9/192), 4% were ENT (8/192), and 4% were ophthalmologists (7/192). The countries with the most reported physician deaths were Italy (79/198), Iran (43/198), China (16/198), Philippines (14/198), United States (9/192) and Indonesia (7/192).CONCLUSIONPhysicians from all specialties may die from COVID, and these deaths will likely increase as the pandemic progresses. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work.

scholarly journals The Italian charter for quality assurance in internal medicine

2013 ◽  
pp. 207-211
Author(s):  
Franco Berti
Keyword(s):  
Internal Medicine ◽  
Health Care ◽  
Quality Assurance ◽  
Health Care Providers ◽  
Health Care Facilities ◽  
Hospital Nurses ◽  
Care Providers ◽  
Patients Rights ◽  
Executive Level

The Italian Charter for Quality Assurance in Internal Medicine is a response to the European Charter of Patients’ Rights presented in Brussels in 2002. It is the product of collaborative efforts by Cittadinanza Attiva (a nonprofit citizens’ rights group), the National Association of Hospital Nurses (ANIMO), and the Federation of Associations of Executive-Level Hospital Internists (FADOI). Its objectives are to enhance respect for patients’ rights and promote uniformity in the quality of care delivered in Italy’s health-care facilities, which is currently characterized by marked inter-regional and inter-hospital variability. This article describes the reasons and principles that have guided the Charter’s elaboration and the benefits of partnership between citizens and health-care providers.

scholarly journals Shared Decision-Making Training in Internal Medicine: A Multisite Intervention Study

2019 ◽  
Vol 11 (4s) ◽  
pp. 146-151 ◽  
Author(s):  
Simon Ritter ◽  
Jerome Stirnemann ◽  
Jan Breckwoldt ◽  
Hans Stocker ◽  
Manuel Fischler ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Decision Making ◽  
Clinical Practice ◽  
Training Program ◽  
Shared Decision Making ◽  
Health Care Providers ◽  
Rating Scale ◽  
Shared Decision ◽  
Care Providers ◽  
Internal Medicine Residents

ABSTRACT Background Research shows that when patients and health care providers share responsibility for clinical decisions, both patient satisfaction and quality of care increase, and resource use decreases. Yet few studies have assessed how to train residents to use shared decision-making (SDM) in their practice. Objective We developed and evaluated a SDM training program in internal medicine. Methods Senior internal medicine residents from 3 hospitals in Switzerland were assessed shortly before and 2 months after completing a program that included a 2-hour workshop and pocket card use in clinical practice. Encounters with standardized patients (SPs) were recorded and SDM performance was assessed using a SDM completeness rating scale (scores ranging from 0 to 100), a self-reported questionnaire, and SPs rating the residents. Results Of 39 eligible residents, 27 (69%) participated. The mean (SD) score improved from 65 (SD 13) to 71 (SD 12; effect size [ES] 0.53; P = .011). After training, participants were more comfortable with their SDM-related knowledge (ES 1.42, P < .001) and skills (ES 0.91, P < .001), and with practicing SDM (ES 0.96, P < .001). Physicians applied SDM concepts more often in practice (ES 0.71, P = .001), and SPs felt more comfortable with how participants discussed their care (ES 0.44, P = .031). Conclusions The SDM training program improved the competencies of internal medicine residents and promoted the use of SDM in clinical practice. The approach may be of interest for teaching SDM to residents in other disciplines and to medical students.

scholarly journals The Relevance and Added Value of Geriatric Medicine (GM): Introducing GM to Non-Geriatricians

2021 ◽  
Vol 10 (14) ◽  
pp. 3018
Author(s):  
Marina Kotsani ◽  
Evrydiki Kravvariti ◽  
Christina Avgerinou ◽  
Symeon Panagiotakis ◽  
Katerina Bograkou Tzanetakou ◽  
...  
Keyword(s):  
Older People ◽  
Health Care Providers ◽  
Geriatric Medicine ◽  
Educational Background ◽  
Added Value ◽  
Care Providers ◽  
Optimal Care ◽  
Allied Health Professionals ◽  
Health And Social Care

Geriatric Medicine (GM) holds a crucial role in promoting health and managing the complex medical, cognitive, social, and psychological issues of older people. However, basic principles of GM, essential for optimizing the care of older people, are commonly unknown or undermined, especially in countries where GM is still under development. This narrative review aims at providing insights into the role of GM to non-geriatrician readers and summarizing the main aspects of the added value of a geriatric approach across the spectrum of healthcare. Health practitioners of all specialties are frequently encountered with clinical conditions, common in older patients (such as cancer, hypertension, delirium, major neurocognitive and mental health disorders, malnutrition, and peri-operative complications), which could be more appropriately managed under the light of the approach of GM. The role of allied health professionals with specialized knowledge and skills in dealing with older people’s issues is essential, and a multidisciplinary team is required for the delivery of optimal care in response to the needs and aspirations of older people. Thus, countries should assure the educational background of all health care providers and the specialized health and social care services required to meet the demands of a rapidly aging society.

scholarly journals Physician deaths from corona virus (COVID-19) disease

2020 ◽  
Vol 70 (5) ◽  
pp. 370-374 ◽  
Author(s):  
E B Ing ◽  
Q (A) Xu ◽  
A Salimi ◽  
N Torun
Keyword(s):  
Internal Medicine ◽  
Health Care Providers ◽  
Protective Equipment ◽  
Care Providers ◽  
Front Line ◽  
Common Cause ◽  
Medical Speciality ◽  
Future Events ◽  
Infectious Disease Specialists ◽  
Line Work

Abstract Background The COVID-19 pandemic has caused much morbidity and mortality to patients but also health care providers. Aims We tabulated the cases of physician deaths from COVID-19 associated with front-line work in hopes of mitigating future events. Methods On 15 April 2020, a Google internet search was performed using the keywords ‘doctor’, ‘physician’, ‘death’, ‘COVID’ and ‘coronavirus’ in English and Farsi, and Chinese using the Baidu search engine. The age, sex and medical speciality of physicians who died from COVID-19 in the line of duty were recorded. Individuals greater than 90 years of age were excluded. Results We found 278 physicians who died with COVID-19 infection, but complete details were missing for 108 individuals. The average age of the physicians was 63.7 years with a median age of 66 years, and 90% were male (235/261). General practitioners and emergency room doctors (108/254), respirologists (5/254), internal medicine specialists (13/254) and anaesthesiologists (6/254) comprised 52% of those dying. Two per cent of the deceased were epidemiologists (5/254), 2% were infectious disease specialists (4/254), 6% were dentists (16/254), 4% were ENT (9/254) and 3% were ophthalmologists (8/254). The countries with the most reported physician deaths were Italy (121/278; 44%), Iran (43/278; 15%), Philippines (21/278; 8%), Indonesia (17/278; 6%), China (16/278; 6%), Spain (12/278; 4%), USA (12/278; 4%) and UK (11/278;4%). Conclusions Physicians from all specialities may die from COVID. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work.

The Case for Dual Training in Geriatric Medicine and Palliative Care: The Time is Now

2017 ◽  
Vol 35 (2) ◽  
pp. 364-370
Author(s):  
Jennifer Gabbard ◽  
Matthew McNabney
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Quality Care ◽  
Geriatric Medicine ◽  
Symptom Burden ◽  
Aging Population ◽  
Chronic Illnesses ◽  
Care Providers ◽  
Care Needs

The majority of older adults die from chronic illnesses which are preceded by years of progressive decline and increasing symptom burden. Delivery of high-quality care cannot take place without sufficient numbers of health professionals with appropriate training and skills in both geriatric and palliative care medicine. Despite the surge in aging population and the majority of deaths being attributed to patients with multiple comorbidities, very few health-care providers undergo dual training in these areas. Thus, the nation is facing a health-care crisis as the number of geriatric patients with chronic disease increasingly outpaces the number of physicians with adequate skills to manage them. Joint training in palliative care and geriatric medicine could prepare physicians to better manage our aging population by addressing all their health-care needs irrespective of their stage of disease emphasizing patient-directed care.

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