scholarly journals The Psychogeriatric Patient in the Emergency Room: Focus on Management and Disposition

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sherry Tang ◽  
Priyanka Patel ◽  
Jagdish Khubchandani ◽  
George T. Grossberg
Keyword(s):  
Emergency Room ◽  
Psychiatric Inpatient ◽  
The Elderly ◽  
The United States ◽  
Psychiatric Consultation ◽  
Urban Hospital ◽  
Geriatric Population ◽  
Psychiatric Inpatient Unit ◽  
The Usa ◽  
Psychogeriatric Patients

Background. The growing geriatric population in the United States (US) has prompted better understanding of treatment of the elderly in the hospital and emergency room (ER) settings. This study examines factors influencing the disposition of psychogeriatric patients after their initial presentation in the ER. Methods. Data was collected on patients 65 years of age or older arriving at the ER of a large urban hospital in the USA (January 2009–December 2010). Results. Of the total subjects (n=95) included in the study, majority were females (66.3%) with an average age of 75.5 years. The chief complaint for psychogeriatric patients coming to the ER was delirium (61.6%). Caucasians were significantly more likely than African-American patients to get a psychiatric consult (33% versus 9%). Patients with delirium were less likely than patients with other psychiatric complaints to get a psychiatric consult in the ER (1.2% versus 47.2%) and less likely to be referred to a psychiatric inpatient unit compared to patients with other psychiatric complaints (2.4% versus 16.7%). Conclusion. Even though delirium is the most common reason for ER visits among psychogeriatric patients, very few delirium patients got a psychiatric consultation in the ER. A well-equipped geriatric psychiatry unit can manage delirium and associated causes.

ELDER ABUSE

1998 ◽  
Vol 18 (4) ◽  
pp. 495-498
Author(s):  
Frank Glendenning
Keyword(s):  
Elder Abuse ◽  
The Elderly ◽  
The United States ◽  
Biological Research ◽  
The European Union ◽  
Health Seeking ◽  
The Usa ◽  
Set Up ◽  
Personal Library ◽  
Public Health Epidemiology

L. B. Cebik, Glenn C. Graber and Frank H. Marsh (eds) Advances in Bioethics: Volume 1: Violence, Neglect and the Elderly. JAI Press Inc., Greenwich, Conn. 1996, 240 pp. £62.50 Hbk ISBN 0-7623-0096-5.This book appears to be the first volume of a series, although it is not clear what additional volumes will follow. The price alone suggests that it is aimed at academic libraries, although serious researchers into elder mistreatment may decide that it is a necessary addition to a personal library as a book of reference.The Preface explains the origin of this series on Advances in Bioethics: ‘The magnitude of violence in the United States has become an increasingly grim reality for many Americans’. Walker and Maltby (1997), in their presentation of European research on ageing, recently drew attention to the sense of fear of walking out at night that older people have in all the member states of the European Union. The same appears to be true in the USA as well. The preface catalogues figures for 1992: 207,000 rapes, over 20,000 murders and 690,000 robberies. This has led the National Institutes of Health (NIH) to focus attention on violence and health, seeking to understand violence-related behaviour and its consequences. In 1993, the NIH set up the Panel of NIH Research on Antisocial, Aggressive and Violence-related Behaviours and their Consequences. The Panel included experts on ethics, criminal justice, medicine, behavioural and biological research, public health, epidemiology, anthropology, nursing, sociology, psychology and psychiatry. The Panel's purpose was to ‘evaluate the NIH research portfolio in terms of its relevance, adequacy and responsiveness to social and ethical concerns.’ It has been necessary to give this background in order that the book may be seen in context.

Characteristics of elderly patients attended at a psychiatry emergency room

2011 ◽  
Vol 26 (S2) ◽  
pp. 834-834 ◽  
Author(s):  
L. Prats ◽  
N. Gual ◽  
P. Lusilla ◽  
A. Gual
Keyword(s):  
Depressive Disorder ◽  
Elderly Patients ◽  
Emergency Room ◽  
Depressive Disorders ◽  
Suicide Attempts ◽  
Psychiatric Symptoms ◽  
Psychiatric Inpatient ◽  
The Elderly ◽  
University Hospital ◽  
Common Diagnosis

IntroductionThere is no general agreement on the prevalence of mental disorders in the elderly, although it is estimated that 25%. of them present psychiatric symptoms. Geriatric psychiatry is one of the most rapidly advancing fields and requires a comprehensive approach.ObjectivesTo analyse the characteristics of patients older than 65 who are attended at the psychiatry emergency room.MethodsA descriptive study was conducted among all elderly pacients seen during May 2010 at the psychiatry emergency room at Vall d’Hebron University Hospital. Clinical variables (functional status, reason to show up, medical history, diagnosis), treatment and referral at discharge were analysed.Results36 patients (44.4% men, mean age 75.3 years) were identified. Charlson comorbidity index was 2.08. Suicide attempts were the most frequent reason for admission (27.8%), followed by psychomotor agitation (16.7%), anxiety disorders (13.9%), delirium (13.9%), depression (11.1%), and behaviour disorders (8.3%). Concerning psychiatric antecedents 58.3% had depressive disorder and 40% reported somatic symptoms during the month prior to their consultation.The most common diagnosis at discharge were anxiety-depressive disorders (52.7%) and delirium (16.7%). The most widely prescribed psychotropics were antipsychotics (19.4% haloperidol, 13.9% quetiapine) followed by benzodiazepines (13.9%). Referral at discharge was: 41.7% home, 13.9% midterm psychiatric units, 27.8% acute psychiatric inpatient unit and 16.7% Internal Medicine.ConclusionsTypically, elderly patients attended at the psychiatric emergency room are diagnosed of an anxiety-depressive disorder and often present with a suicidal attempt, but only 41.7% are admitted as psychiatric inpatients.

scholarly journals Lessons of mortality following COVID-19 epidemic in the United States especially in the geriatrics

2020 ◽  
Vol 10 (1) ◽  
pp. e06-e06
Author(s):  
Majid Daneshfar ◽  
Nahid Dadashzadeh ◽  
Mohammad Ahmadpour ◽  
Hedieh Ragati Haghi ◽  
Vahid Rahmani ◽  
...  
Keyword(s):  
Close Contact ◽  
The Elderly ◽  
The United States ◽  
Geriatric Population ◽  
Infected People ◽  
Metropolitan County ◽  
Yellow Color ◽  
Novel Coronavirus ◽  
Respiratory Droplets ◽  
Metropolitan Counties

COVID-19 is spreading all around the world, and is considered as the most widespread infectious disease of the century. Coronavirus transmits through respiratory droplets when in close contact with the infected person. Therefore, populous places are more likely to be the source of the novel coronavirus that is threatening the health of everyone especially the geriatric population. This study aimed to compare the transmission of coronavirus between metropolitan and non- metropolitan counties as lessons of mortality (especially in geriatric) following COVID-19 epidemic. The USAFact.org public website (https://usafacts.org/visualizations) was used to determine the transmission between metro and non- metropolitan counties. In this study, four different time periods were considered for the COVID-19 incremental trend (April 1, May 1, June 1, and July 1, 2020). The number of cases was determined per each 10,000 population. Yellow color means no case in the metropolitan county (metro). Orange color means less than 10 cases/10,000 of the population in metro. Figure and maps were used to show the objectives of the study. In metropolitan counties, the spread of COVID-19 is very fast, which is significantly different from the non-metro counties (P<0.001). The results show the sharp increasing trend of infected people in metropolitan counties. In metropolitan counties the number of infected people reached 2 420 316 cases per 10 000 populations but the number of infected people reached 231 459 cases per 10 000 populations. Over the four months period, the frequency of the light colors was decreased. According to the results, susceptible people especially the elderly should move to non- metropolitan counties during the COVID-19 pandemic to be less likely at risk.

scholarly journals A Canadian Medical-Psychiatric Inpatient Service*

1992 ◽  
Vol 37 (5) ◽  
pp. 326-334 ◽  
Author(s):  
J. Robert Swenson ◽  
François M. Mai
Keyword(s):  
Somatoform Disorders ◽  
Psychiatric Inpatient ◽  
The United States ◽  
Inpatient Service ◽  
Adequate Care ◽  
Psychiatric Inpatient Unit ◽  
Present Complex ◽  
Psychiatric Units ◽  
Adult Inpatient ◽  
One Year

Patients with both psychiatric and medical illnesses present complex and, at times, difficult diagnostic and management problems. Medical-psychiatric units designed to provide integrated medical and psychiatric care have been established in the United States. This paper describes the development and structure of such a unit established at a Canadian general hospital, using psychiatric facilities and resources already in place. A one year review of the characteristics of patients discharged from the service found that their mean length of stay was similar to that of inpatients discharged from the general adult inpatient services, but shorter than that of patients discharged from the psychogeriatric service. Many of these patients had neurological conditions; coexisting affective disorders, substance abuse, organic mental syndromes and somatoform disorders were diagnosed frequently. We believe that a medical-psychiatric inpatient unit can provide integrated care to patients who might otherwise receive less than adequate care.

Geriatric Psychiatry and Fellowship Programs in the United States

2008 ◽  
Vol 9 (4) ◽  
pp. 180-185
Author(s):  
David Cordon
Keyword(s):  
United States ◽  
The Elderly ◽  
The United States ◽  
Consensus Conference ◽  
Geriatric Population ◽  
Symptoms Of Depression ◽  
Community Residents ◽  
Fellowship Programs ◽  
Clinically Significant ◽  
Commit Suicide

Psychiatric disorders are extremely common in the elderly and are a major cause of morbidity and mortality. For example, 8% to 15% of the geriatric population has clinically significant symptoms of depression (NIH Consensus Conference, 1992). Elderly Americans commit suicide at a rate twice the national average (National Strategy for Suicide Prevention, 2007). Ten to 15% of elderly community residents have Alzheimer’s disease (AD) or other dementias (Evans et al., 1989). AD is the seventh-leading cause of death in the United States (Centers for Disease Control, 2006).

scholarly journals Patterns of mortality during pandemic: An example of Spanish flu pandemic of 1918

2020 ◽  
Vol 4 (2) ◽  
pp. 56-64 ◽  
Author(s):  
Natalia S. Gavrilova ◽  
Leonid A. Gavrilov
Keyword(s):  
Middle Ages ◽  
Latent Variables ◽  
Total Mortality ◽  
The Elderly ◽  
The United States ◽  
Mortality Factor ◽  
Main Peak ◽  
Mortality Trends ◽  
The Usa ◽  
Spanish Flu

Now the attention of the whole world is focused on the developing pandemic of the coronavirus infection COVID-19. This article discusses mortality patterns of the deadliest epidemic in the last 120 years – the Spanish flu pandemic of 1918. Statistical sources from Italy and the USA, published shortly after the pandemic, were analyzed. The analysis was carried out for mortality from all causes, since in this case inaccuracies associated with establishing the causes of death are minimized. Despite the fact that the first cases of the Spanish flu appeared in the United States as early as March 1918, this first wave of epidemic practically did not affect the total mortality rate. The main peak of mortality in 1918 occurred in October 1918 both in the USA and Italy, with a gradual decrease in mortality over several months. Analysis of age-specific mortality demonstrates a significant increase in mortality at middle ages (20-50 years) in 1918 compared with 1917. Analysis of mortality trends using the method of latent variables shows a significant increase in the background mortality factor in 1918, which turned out to be higher for Italy than the mortality losses during the Second World War. The Spanish flu pandemic differs from the current coronavirus pandemic, because of significant increase in mortality of middle-aged people, while the COVID-19 pandemic causes a more marked increase in mortality among the elderly. With this, the COVID-19 pandemic is more like the recent flu epidemics than the earlier Spanish flu pandemic.

Sociopathy, Antisocial Personality, and Directed Aggression in the Geriatric Population

2017 ◽  
Author(s):  
Olivia Zurek ◽  
Laura Stanton ◽  
Robert Kohn
Keyword(s):  
Violent Behavior ◽  
Criminal Activity ◽  
The Elderly ◽  
The United States ◽  
Epidemiological Studies ◽  
Elderly Persons ◽  
Antisocial Personality ◽  
Geriatric Population ◽  
Aggravated Assault ◽  
Sizable Proportion

Elderly persons are not often thought of as being associated with criminal activity. Among the elderly for both genders, however, the percentage of persons arrested in the United States for violent crimes increased significantly from 1995 to 2013, this increase being due to more aggravated assault arrests. Epidemiological studies on antisocial personality disorder and FBI crime statistics provide an understanding of sociopathy and directed aggression in the geriatric population. This chapter addresses the risk factors for violent behavior among elderly persons and provides U.S. crime data for persons age 65 and older, presented by type of crime and by gender and race of perpetrators. The act of homicide among elderly persons is given particular attention. The chapter also discusses the role of dementia in crimes committed by elderly persons, as a sizable proportion of persons with dementia take part in criminal activity, particularly theft, although rates differ according to type of neurocognitive disorder.

scholarly journals The progression of chronic renal failure: An unmet challenge

1998 ◽  
Vol 2 (1) ◽  
pp. 1-6
Author(s):  
A M El Nahas ◽  
N Tamimi
Keyword(s):  
Renal Failure ◽  
Chronic Renal Failure ◽  
Native Americans ◽  
Replacement Therapy ◽  
The Elderly ◽  
The United States ◽  
Systemic Hypertension ◽  
Number Of Patients ◽  
The Usa ◽  
Acceptance Rates

An increasing number of patients require dialysis replacement therapy every year in Europe. This reflects the large number of patients with chronic renal failure (CRF) and the progressive nature of their underlying nephropathies. Worldwide, the annual incidence of acceptance rates on renal replacement programmes varies between 25 patient per million of population (pmp) in some developing countries to 58.6 pmp in Europe, 169 pmp in the USA [I] and 194.2 pmp in Japan [2]. In Europe, there are in excess of 312 pmp on replacement therapy with France having one of the highest prevalence within the continent with 628 pmp [3]. Further, there are important differences in the incidence of end stage renal failure (ESRF) according to age, gender and race. In Western countries, the incidence of ESRF is lowest in children (10 pmp/year) and highest in the elderly (> 400 pmp/year in patients over the age of 75). The incidence of ESRF is higher in males. In the United States, the incidence of ESRF is higher in Afro-Carribeans and native Americans [4]. This reflects both an increased prevalence of CRF in these ethnic minorities as well as a higher rate of progression [4]. It also reflects the higher incidence of systemic hypertension and diabetic nephropathy in black and native Americans respectively [4].In the United Kingdom, the incidence of ESRF is higher in Asians [5].

Highlights From the 2019 AGS Beers Criteria® Updates

2020 ◽  
Vol 35 (2) ◽  
pp. 68-74
Author(s):  
Creaque V. Charles ◽  
Angie Eaton
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Data Extraction ◽  
Inappropriate Medication ◽  
The Elderly ◽  
The United States ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Geriatric Population ◽  
Inappropriate Medications

OBJECTIVE: To compare the 2015 and 2019 AGS Beers Criteria® of potentially inappropriate medications in the elderly.<br/> DATA SOURCES: American Geriatrics Society 2015 and 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication (PIM) Use in Older Adults published literature.<br/> STUDY SELECTION/DATA EXTRACTION: The literature was reviewed, compared, and summarized to identify pertinent changes and updates to the AGS Beers Criteria of PIMs in the elderly.<br/> DATA SYNTHESIS: The AGS Beers Criteria® contains a list of potentially inappropriate medications that should be used with caution, avoided, notable drug-drug interactions, and drugs that should be dose-adjusted based on kidney function in the older adult. The updated AGS Beers Criteria® also includes removal of medications that are no longer sold in the United States, have a low usage rate, provide low evidence of harm, and/or the potential harm is not unique to the older adult.<br/> CONCLUSION: The AGS Beers Criteria® is intended to improve and optimize the care of the geriatric population. It serves as a guide to minimize older adults' exposure to PIMs whenever possible. As with previously published updates to the AGS Beers Criteria®, the 2019 update outlines the following: recommendations, rationale, and quality of the recommendations, as well as the strength of the recommendations.

scholarly journals Impact Analysis of Coronavirus on Elderly Population in Worldwide and Kazakhstan

2021 ◽  
Author(s):  
Assel Izekenova ◽  
Akbota Tolegenova ◽  
Aigulsum Izekenova ◽  
Alina Rakhmatullina
Keyword(s):  
Elderly Population ◽  
Impact Analysis ◽  
Age Groups ◽  
The Elderly ◽  
Easy Access ◽  
Geriatric Population ◽  
Aging Studies ◽  
The World ◽  
The Usa ◽  
Severity Of The Disease

Covid-19 pandemics has affected the lives of all level population but brought an unprecedented threat to the health and daily life of the elderly population. Starting from Huanan Seafood Market in Wuhan, China, the virus spread to the world fleetingly, from 44 cases in January 2019 to 171,615,923 cases all around the world as of June 01, 2021, including Kazakhstan. SARS-CoV-2 positive patients had shown asymptomatic, mild, severe, and critical symptoms which brought to respiratory failure, shock, or multiorgan dysfunction in 5% of cases. The severity of the disease correlated with the older age and existing medical conditions, making the geriatric population more at hazard. A remarkable superiority of cases and deaths of Covid-19 was found within the elderly group, and particularly in those with pre-existing conditions and comorbidities, additionally to the immunosenescence and inflamm-aging. Studies done in the USA, Europe, and Asian countries showed a similar prevalence of the disease among adults and older people, but the mortality was extremely higher than in other age groups. Despite the similar prevalence, Kazakhstani researchers revealed a higher mortality rate (83.3%) than those countries. Therefore, the world, especially developing countries, needs additional advanced policies in vaccination policy, immediate testing, easy access to healthcare and information without ageist biases, income security, and more researches should be done that can address the issues, improve the lives and diminish the mortality of the geriatric population.

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