Frequent problems and their management among mechanically ventilated critically ill elderly patients

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Watchara Tabootwong ◽  
Frank Kiwanuka
Keyword(s):  
Elderly Patients ◽  
Critically Ill ◽  
Health Care Professionals ◽  
Respiratory Infections ◽  
Psychological Problems ◽  
Pharmacological Management ◽  
Content Type ◽  
Mechanically Ventilated ◽  
Age Related ◽  
Management Of Complications

Purpose Multiple pathologies and age-related physiological changes lead to acute respiratory failure. This necessitates mechanical ventilation among elderly patients. Mechanically ventilated critically ill elderly patients may confront various problems, including physical and psychological issues. Therefore, the purpose of this paper is to present the frequent problems encountered by critically ill elderly patients and management of such problems. Design/methodology/approach This paper reviews relevant literatures. Findings Physical problems include pain and respiratory infections. Additionally, psychological problems include anxiety and stress. Such problems should be managed by physicians, nurses and family members. Pharmacological and non-pharmacological approaches can be used to manage these problems. Pharmacological management involves use of medications, while non-pharmacological interventions include use of music therapy, acupuncture and sensory stimulation. Originality/value The paper indicates physical and psychological problems of mechanically ventilated critically ill elderly patients. To ensure effective management of complications encountered by mechanically ventilated elderly patients, health-care professionals ought to be aware of physical and psychological age-related changes.

Achieving shared understanding in chronic care interactions: the role of caregivers

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Sarah Bigi
Keyword(s):  
Health Care ◽  
Elderly Patients ◽  
Health Care Professionals ◽  
Chronic Care ◽  
Second Step ◽  
Original Research ◽  
Clinical Settings ◽  
Shared Understanding ◽  
Content Type

Purpose Within the context of a research program on the most relevant discourse types in chronic care medical encounters, this contribution reports on a qualitative study on the role caregivers play within the process of shared understanding occurring between health-care professionals and elderly patients. The purpose of the paper is to highlight one dimension of such complexity, by bringing to light the challenges connected to the achievement of shared understanding between health-care professionals and elderly patients when caregivers are involved in the conversation. Design/methodology/approach The paper reports on a two-step analysis of a corpus of transcripts of interactions in diabetes and hypertension settings. In the first step, caregivers’ contributions to deliberative sequences have been analyzed. In the second step, the analysis was extended to caregivers’ contributions to the whole encounter. Findings The results show that professionals’ ability to engage caregivers in deliberations during the encounter and, more generally, to assign a role to caregivers as legitimate participants in the consultation may favor the smooth development of the interaction and an effective process of shared understanding among all participants. Originality/value The paper further develops original research about the functions of the argumentative component in dialogues occurring in clinical settings.

Family caregiver participation in caregiving for hospitalized elderly patients with a tracheostomy: a literature review

2020 ◽  
Vol 24 (2) ◽  
pp. 105-111 ◽  
Author(s):  
Watchara Tabootwong ◽  
Frank Kiwannuka
Keyword(s):  
Health Care ◽  
Literature Review ◽  
Elderly Patients ◽  
Family Caregivers ◽  
Family Caregiver ◽  
Health Care Professionals ◽  
Therapeutic Process ◽  
Content Type ◽  
Hospitalized Elderly ◽  
Hospitalized Elderly Patients

Purpose Elderly patients requiring prolonged mechanical ventilation are treated with a tracheostomy. Oftentimes, the family caregivers need to participate in the care for elderly patients with a tracheostomy during hospitalization. Therefore, this paper was conducted to acknowledge what family caregivers experience while caregiving for hospitalized elderly patients with a tracheostomy. Design/methodology/approach This literature review identifies family caregiver participation in caregiving for the elderly patient, the impact of caregiving, and the needs of family caregivers. Findings Family caregivers participate in the planning and provision of care to elderly patients. Furthermore, they also collaborate in the therapeutic process for elderly patients as well. Albeit the former sentiments, they experience physical, psychological, social and financial consequences of caregiving. It has been revealed that during the process of caring for their loved ones, family caregivers often experience poor sleep quality, strain, reduction in social interaction and insufficient income. Thus, health-care professionals should support and provide care for the needs of family caregivers. This can be achieved through providing information on prognosis, the care plan, emotional support and collaboration during the therapeutic process to provide better care for elderly patients with a tracheostomy. In addition, family caregivers’ relatives can also provide financial support and rotation of caregiving schedules to avoid burnout. Originality/value The paper indicates that family caregivers experience the impacts of caregiving. They should be supported by health-care professionals and their relatives.

Body image and body work among older women: a review

2014 ◽  
Vol 7 (4) ◽  
pp. 198-210 ◽  
Author(s):  
Catherine E. Marshall ◽  
Christina O. Lengyel ◽  
Verena H. Menec
Keyword(s):  
Body Image ◽  
Older Women ◽  
Health Care Professionals ◽  
Well Being ◽  
Future Research ◽  
Hair Dye ◽  
Body Work ◽  
Content Type ◽  
Age Related ◽  
Body Image Issues

Purpose – The purpose of this paper is to review the literature on body image and aging among older women. Using existing qualitative research, this paper explores how aging affects body image and how women respond to body image issues as they age. Design/methodology/approach – Multiple databases were used to locate original and review articles on the topics of body image and aging, with a target population of women ages 60 years and older. The findings of the literature search were compiled, summarized and sorted to create themes. Findings – Women struggle with body image issues throughout their lives. Women tend to perceive age-related changes in appearance negatively, as a threat to their identity and social value. This is due, in part, to the sociocultural environment, which pressures women to “fight” aging and maintain an ideal (young and thin) image at all costs. Some women do come to terms with their aging body and report increased self-acceptance with age. However, others turn to various forms of body work (e.g. dieting, hair dye, makeup) in order to maintain their value in an appearance-based society. Practical implications – Poor body image can affect older women's emotional, psychological and physical health and overall well-being. Health care professionals, community workers and policy makers need to be made aware of these issues so that they can respond appropriately. Originality/value – There has been limited research exploring body image among older women. This paper identifies gaps in the literature and suggests avenues for future research in this area.

Energy Needs Are Poorly Predicted in Critically Ill Elderly

1997 ◽  
Vol 12 (1) ◽  
pp. 45-49 ◽  
Author(s):  
R. Sheridan ◽  
K. Prelack ◽  
L. Yin ◽  
Vincent Riggi
Keyword(s):  
Energy Expenditure ◽  
Elderly Patients ◽  
Critically Ill ◽  
Indirect Calorimetry ◽  
Resting Energy Expenditure ◽  
Apache Ii Score ◽  
Mechanically Ventilated ◽  
Energy Needs ◽  
Expired Gas ◽  
Resting Energy

Changes in energy expenditure with age have been described, but this physiology is not routinely considered when managing critically ill elderly patients. To allow us to avoid the potential problems associated with underfeeding or overfeeding the critically ill elderly population, with approval of the human studies committee and appropriate consent from legal guardians, 25 critically ill patients over 65 years of age requiring mechanical ventilation underwent expired gas indirect calorimetry. If they had a pulmonary artery catheter in place for clinical reasons, reverse-Fick indirect calorimetry was also performed. Data obtained by indirect calorimetry was compared with commonly applied equations for predicting energy expenditure by statistical methods of correlation and limits of agreement. These 25 patients had an average age of 74 ± 1.23 (standard error of the mean) and an average APACHE II score of 15. Predictive equations correlated poorly with measured resting energy expenditure, and although they showed reasonable bias, they were imprecise in their estimation of resting energy expenditure. These data suggest that energy expenditure in critically ill, mechanically ventilated elderly patients is highly variable. Although generally overestimating energy needs, currently available equations for predicting energy expenditure in this population are associated with significant bias and imprecision, which may lead to both overfeeding and underfeeding. Although these equations may be suitable as a basis of initiating nutritional support, energy provisions should ideally be guided by indirect calorimetry.

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