Education and skills training for care partners of hospitalised older adults: A scoping review

2021 ◽  
pp. 001789692110341
Author(s):  
Madeline Carbery ◽  
Samantha Schwartz ◽  
Nicole Werner ◽  
Beth Fields
Keyword(s):  
Older Adults ◽  
Hospital Admission ◽  
Health Outcomes ◽  
Older Adult ◽  
Scoping Review ◽  
Hospital Care ◽  
Skills Training ◽  
Individual Care ◽  
Care Partners ◽  
The Usa

Background: The care partners of hospitalised older adults often feel dissatisfied with the education and skills training provided to them, resulting in unpreparedness and poor health outcomes. Objective: This review aimed to characterise and identify gaps in the education and skills training used with the care partners of older adults in the hospital. Methods: We conducted a scoping review on the education and skills training practices used with the care partners of hospitalised older adults in the USA via sources identified in the PubMed, PsychINFO and CINAHL databases. Results: Twelve studies were included in this review. Results illustrate that nurses utilise multiple modes of delivery and frequently provide education and skills training tailored to the needs of care partners at the latter end of hospital care. The provision of education and skills training varies greatly, however, including who provides education, in what way information is conveyed, and how care partner outcomes are measured. Conclusion: This is the first scoping review to describe and synthesise the education and skills training practices used with care partners of hospitalised older adults. Findings highlight the need for education and skills training to be interprofessional, tailored to individual care partners’ needs and begin at, or even before, the hospital admission of older adult patients.

scholarly journals Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses

2021 ◽  
pp. 155982762110012
Author(s):  
Fei-Chi Yang ◽  
Aishwarya B. Desai ◽  
Pelareh Esfahani ◽  
Tatiana V. Sokolovskaya ◽  
Doreen J. Bartlett
Keyword(s):  
Older Adults ◽  
Health Promotion ◽  
Health Outcomes ◽  
Scoping Review ◽  
General Health ◽  
Tai Chi ◽  
Well Being ◽  
Cochrane Library ◽  
Care Providers ◽  
Meta Analyses

Background. Tai Chi is a form of exercise that is accessible to people from different socioeconomic backgrounds, making it a potentially valuable activity for health promotion of older adults. Purpose. The objective of this scoping review was to summarize the current knowledge about the effectiveness of Tai Chi for older adults across a range of general health outcomes from published, peer reviewed, unique meta-analyses. Methods. Meta-analyses were retrieved from Medline, Embase, AMED, CINAHL, SPORTDiscus, PsychINFO, Web of Science, PubMed Health, and the Cochrane Library from database inception to late August 2019. Multistage deduplication and screening processes identified eligible full-length meta-analyses. Two people independently appraised 27 meta-analyses based on the GRADE system and organized results into 3 appendices subsequently collated into heterogeneous, statistically significant, and statistically insignificant tables. Results. “High” and “moderate” quality evidence extracted from these meta-analyses demonstrated that practicing Tai Chi can significantly improve balance, cardiorespiratory fitness, cognition, mobility, proprioception, sleep, and strength; reduce the incidence of falls and nonfatal stroke; and decrease stroke risk factors. Conclusions. Health care providers can now recommend Tai Chi with high level of certainty for health promotion of older adults across a range of general health outcomes for improvement of overall well-being.

scholarly journals Management of bio-psycho-social frailty to reduce hospital use and improve survival of older adults

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
G Liotta ◽  
N Accarino ◽  
S Orlando ◽  
S Gentili ◽  
E Terracciano ◽  
...  
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Health Outcomes ◽  
Social Isolation ◽  
Hospital Care ◽  
Admission Rate ◽  
Term Care ◽  
Hospital Admission Rate ◽  
Starting Point ◽  
The Impact

Abstract Background Ageing of population is associated to the increase of care demand. Many health systems are still centered on hospital care, that sometime is not appropriate. The shift from hospital to community care requires a new model of service delivery. Aim of this paper is to assess the impact of a community service based on the assessment of frailty, on mortality and use of hospital care by older adults. Methods A cohort made up by 8,592 over-75 subjects (67.1% female, mean age 84.5; SD ± 5.29) has been assessed once a year for bio-psycho-social frailty by the administration of the Short Functional Geriatric Evaluation questionnaire. The enrolled subjects were involved in a Community-based pro-Active Monitoring Program which provides interventions aimed at reducing social isolation. Mortality, use of hospital care and use of residential long-term care have been recorded during the follow up and separate and cumulative incidence rate was measured. Results The sample was stratified in Robust (37.5%), Pre-frail (24.0%), Frail, (29.5%) and Very Frail (9.1%) individuals. Mortality, Hospital admission rate and Residential LTC admission rate were higher in the very frails than among the other groups. However, according to social isolation, the integrated subjects at the baseline assessment, showed the highest incidence of negative events: 29.5%, 20.8%, 21.0%, .and 20.8% for integrated, mild isolated, moderate isolated and severely isolated individuals respectively (p < 0.001). The logistic regression analysis, adjusted for age, gender and level of frailty, confirmed the protective role of reducing social isolation among isolated individuals compared with integrated ones (OR: 0.729; CL95% 0.673-0.720). Conclusions The assessment of bio-psycho-social frailty could be the starting point for effective intervention at community level, like the program mentioned above. Management of frailty may lead to an improvement of public health outcomes. Key messages Intervention dealing with social isolation are able to revert the increase of mortality related to the lack of social resources. Management of frailty may lead to an improvement of public health outcomes.

scholarly journals Dynapaenic obesity and its association with health outcomes in older adult populations: protocol for a systematic review

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e027728 ◽  
Author(s):  
Siobhan Leahy ◽  
Marica Cassarino ◽  
Matthew DL O' Connell ◽  
Liam Glynn ◽  
Rose Galvin
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Health Outcomes ◽  
Older Adult ◽  
Observational Studies ◽  
Functional Disability ◽  
Age Groups ◽  
Ageing Population ◽  
Cross Sectional ◽  
Age Related

IntroductionTwo major global health challenges are the rapidly ageing population and the high prevalence of obesity in all age groups. Older adults are also susceptible to age-related loss of muscle strength, termed dynapaenia. The co-occurrence of both obesity and dynapaenia, termed dynapaenic obesity (DO), has been associated with poorer health outcomes and increased healthcare usage compared with either state alone. The purpose of this systematic review is to quantify the prevalence and incidence of DO in older adult populations, and to explore the association between DO and health outcomes, specifically chronic disease and multimorbidity, functional disability and healthcare usage.Methods and analysisUsing the Meta-analyses Of Observational Studies in Epidemiology guidelines, we will conduct a systematic review of cross-sectional and longitudinal observational studies of older adults, which include measures of DO and specified outcomes. Detailed literature searches of will be conducted using six electronic databases: Excerpta Medica dataBASE (EMBASE), PubMed, MEDLINE, SCOPUS, ScienceDirect and Cumulative Index of Nursing and Allied Health Complete (CINAHL), including articles published from database inception until Febuary 2019. The reference lists of included articles will also be searched. Two independent reviewers will undertake a three-step screening and review process using the Population, Risk Factor, Outcome framework to define eligibility. The Newcastle Ottawa Scale for non-randomised studies will be used to assess risk of bias and to rate study quality. The findings will be synthesised in a narrative summary, and a meta-analysis will be conducted where appropriate.Ethics and disseminationEthical approval is not required for this systematic review. Findings from this research will be submitted for peer-reviewed publication in academic journals, and presented at relevant academic conferences.PROSPERO registration numberCRD42018112471.

Defining undertreatment and overtreatment in older patients with cancer: A scoping review of the literature.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23020-e23020
Author(s):  
Clark DuMontier ◽  
Kah Poh Loh ◽  
Paul A Bain ◽  
Rebecca A Silliman ◽  
Gregory A. Abel ◽  
...  
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Scoping Review ◽  
Standard Therapy ◽  
Older Patients ◽  
Review Of The Literature ◽  
Substantial Agreement ◽  
Explicit Definition ◽  
Patients With Cancer ◽  
Implicit Definitions

e23020 Background: The terms “undertreatment” and “overtreatment” are often used to describe the management of older adults with cancer. The aim of this scoping review was to explore the explicit and implicit definitions associated with the use of these terms. Methods: We searched PubMed (NCBI), Embase (Elsevier), and CINAHL (EBSCO) for titles and abstracts that included the terms "undertreatment" or "overtreatment" (overtreat OR undertreat OR over treat OR under treat) of older adults with cancer. We included all types of articles, cancers, and treatments. We excluded studies that only included patients younger than 60 years old or studies without a defined focus on older adults. CD and KL independently reviewed a subset of included articles to assess for inter-reviewer reliability. Results: We identified 224 primary and secondary research articles that used the terms “undertreatment” (192), “overtreatment” (72), or both (45) regarding the management of older adults with cancer. Only 14 (6.3%) articles provided an explicit definition; for the remaining articles, we derived the implicit definitions from the terms’ surrounding context. There was substantial agreement between CD and KL in their interpretation of definitions of these terms (kappa 0.81). “Undertreatment” was commonly used to imply less than “standard” therapy (130 articles, 67.7%), or less than “standard” therapy that contributed to worse outcomes (62, 32.3%). Many articles did not account for the underrepresentation of older adults in trials leading to “standard” therapy, and 24 primary studies performed no or limited adjustment for geriatric domains (e.g., function) in their analyses that suggested worse survival in older adults treated with substandard therapy. “Overtreatment” was commonly used to imply cancer treatment in an older adult whose cancer would not have caused symptoms in his/her remaining lifetime (31, 43.1%), or aggressive treatment in whom the harms of treatment outweigh its benefits (41, 56.9%). Conclusions: Nearly all articles used the terms “undertreatment” and/or “overtreatment” without an explicit definition, and we identified variability and limitations in the meanings implied by these terms.

scholarly journals Engaging Older Adults in Technology Research: Perspectives on Barriers and Facilitators Using a Case Study Approach

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 821-821
Author(s):  
Susan Kirkland
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Skills Training ◽  
Decision Makers ◽  
Longitudinal Case Study ◽  
Study Approach ◽  
Active Involvement ◽  
Research Perspectives ◽  
Meaningful Engagement

Abstract The aim of OA-INVOLVE is to provide recommendations to support older adult engagement in research that leads to the successful development of technologies for and with older adults. To support this aim we conducted a longitudinal case study project in which we interviewed eight AGE-WELL research teams conducting technology projects to explore the benefits, challenges, and solutions for meaningful engagement. Members of the OA-INVOLVE Older Adult Research Partner Group (OARPG) were involved in all aspects of the project. Findings from the case studies provided important insights regarding structural, contextual, and individual factors that enable and constrain active involvement of older adults. Many projects reported developing unique “workarounds” in order to move beyond involving older adults as participants to involving them as advisors and decision makers. Researchers identified that they often lack the skills, training and resources to engage older adults in a meaningful way and could benefit from capacity building.

scholarly journals Dietary Patterns and health outcomes among older adults: A protocol for scoping review

2021 ◽  
Author(s):  
Parimala Mohanty ◽  
Sangeetha Shyam ◽  
Harvinder Kaur A/P Gilcharan Singh ◽  
Lipilekha Patnaik ◽  
Ambarish Dutta
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Scoping Review ◽  
Dietary Patterns

scholarly journals Evaluating the Appropriateness and Feasibility of the Care Partner Hospital Assessment Tool (CHAT)

2021 ◽  
Vol 18 (24) ◽  
pp. 13355
Author(s):  
Madeline Carbery ◽  
Richard Schulz ◽  
Juleen Rodakowski ◽  
Lauren Terhorst ◽  
Beth Fields
Keyword(s):  
Older Adults ◽  
Mixed Method ◽  
Assessment Tool ◽  
Phase 1 ◽  
Qualitative Interviews ◽  
Skill Training ◽  
Skills Training ◽  
Hospital Administrators ◽  
Care Partners ◽  
Hospitalized Older Adults

Hospital practitioners rely on care partners of older adults to provide complex care without identifying and addressing their needs. The Care Partner Hospital Assessment Tool (CHAT) was developed to identify the education skill training needs of care partners of hospitalized older adults. This two-phased mixed-method study evaluated the appropriateness and feasibility of the CHAT. The phase 1 quantitative survey with caregiving experts indicated 70–100% agreement for the length and helpfulness of the CHAT (n = 23). These results were supported by phase 2 qualitative interviews with hospital administrators and practitioners, which revealed the following themes: (1) intuitive and clear design worth sustaining and (2) concerns and proposed solutions for implementation. Findings suggest the CHAT is an appropriate and feasible tool for hospital practitioners to tailor their education and skills training to address care partners’ needs. Identifying care partners’ needs is an important step in ensuring they are prepared to complete their caregiving responsibilities.

A Scoping Review of the Evidence About the Nurses Improving Care for Healthsystem Elders (NICHE) Program

2019 ◽  
Author(s):  
Allison Squires ◽  
Komal Patel Murali ◽  
Sherry A Greenberg ◽  
Linda L Herrmann ◽  
Catherine O D’amico
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Quality Of Care ◽  
Work Environment ◽  
Older Adult ◽  
Patient Outcomes ◽  
Scoping Review ◽  
Adult Care ◽  
Program Adoption

Abstract Background and Objectives The Nurses Improving Care for Healthsystem Elders (NICHE) is a nurse-led education and consultation program designed to help health care organizations improve the quality of care for older adults. To conduct a scoping review of the evidence associated with the NICHE program to (a) understand how it influences patient outcomes through specialized care of the older adult and (b) provide an overview of implementation of the NICHE program across organizations as well as its impact on nursing professionals and the work environment. Research Design and Methods Six databases were searched to identify NICHE-related articles between January 1992 and April 2019. After critical appraisal, 43 articles were included. Results Four thematic categories were identified including specialized older adult care, geriatric resource nurse (GRN) model, work environment, and NICHE program adoption and refinement. Specialized older adult care, a key feature of NICHE programs, resulted in improved quality of care, patient safety, lower complications, and decreased length of stay. The GRN model emphasizes specialized geriatric care education and consultation. Improvements in the geriatric nurse work environment as measured by perceptions of the practice environment, quality of care, and aging-sensitive care delivery have been reported. NICHE program adoption and refinement focuses on the methods used to improve care, implementation and adoption of the NICHE program, and measuring its impact. Discussion and Implications The evidence about the NICHE program in caring for older adults is promising but more studies examining patient outcomes and the impact on health care professionals are needed.

scholarly journals Factors Contributing to Older Adults Living Alone and Thereby at Risk of Poor Health and Adverse Health Outcomes

2019 ◽  
Author(s):  
Nikki Shipley
Keyword(s):  
Older Adults ◽  
At Risk ◽  
Health Status ◽  
Health Outcomes ◽  
Older Adult ◽  
Living Arrangements ◽  
Age At Onset ◽  
Poor Health ◽  
Living Child ◽  
Living Alone

Introduction: Extensive research demonstrates that older adults living alone tend to be less healthy, have poorer health outcomes and are at greater risk of dying. While many investigators have explored various aspects of aging, there has been limited work assessing factors that increase the chances of an older adult to live alone. This study examines the association between demographic characteristics; current health status; and social, cultural, and environmental factors among older adults (65 years of age and older) and the likelihood they will live alone Methods: Secondary analyses is conducted of survey data from the Americans' Changing Lives (ACL) cohort study initiated in 1986 (Wave 1) and continued through 2012, with four follow-up surveys conducted in 1989 (Wave II), 1994 (Wave III), 2001/02 (Wave IV), and 2011/12 (Wave V). All ACL participants 65 years and older at time of survey (Wave I – V) are included for this study (N=7,020). An analysis of variance (ANOVA) that included demographics, health status, and social support factors is employed to determine the relationship of these variables to an older adult reporting living alone. Additionally, the Cox proportional hazards model is used for survival analysis to predict the expected age at onset of living alone. Results: Four critical factors reduce the probability of an older adult living alone: 1) marital status (married), 2) gender (male), 3) presence of at least one living child, and 4) willingness to spend time in the garden (physical activity). An older female adult who is currently single and without a living child is most likely to report living alone (p<.001). Conclusions: Older adults living alone are at higher risk of poor health and health outcomes. The influx of baby boomers whose life expectancy is longer than the past, will cause a dramatic increase in senior adults living alone. This research suggests a guideline to public health professionals for identifying those at risk of being negatively impacted by living alone so that they can intervene and provide alternative living arrangements and support services, as necessary. Keywords: living alone, older adults, health outcomes

scholarly journals Intergenerational Engagement in Residential Settings: A Scoping Review of the Literature

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 851-851
Author(s):  
Andrea Gardiola ◽  
Raza Mirza ◽  
Amanda Bull ◽  
Christopher Klinger ◽  
Jessica Hsieh ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Scoping Review ◽  
Grey Literature ◽  
Age Groups ◽  
Future Research ◽  
Long Term Effects ◽  
Hand Search ◽  
Intergenerational Interactions ◽  
The Impact

Abstract Intergenerational engagement provides a rich environment for people of different ages to come together and exchange life stories, skills, and knowledge. Today, intergenerational interactions are decreasing, however, these exchanges can have positive implications for seniors in residential care homes (RCHs) and younger persons. A scoping review following Arksey and O’Malley’s five-step framework was conducted to investigate the impact of intergenerational engagement and programs (IGPs) on older adults in RCHs. A systematic search of ten electronic databases and hand search of references was carried out; thematic content analysis to established key themes. A total of 1,183 academic and grey literature sources were reviewed, with 66 full-text studies assessed for eligibility. Of these sources, 35 studies met inclusion criteria. Studies highlighted four main themes: 1. Types of IGPs, 2. Psycho-social benefits for older adults and improved status among elders with cognitive impairments, 3. Younger person benefits, suggesting reduced ageism and improved social and communication skills, and 4. Program recommendations, including the need for enthusiastic program facilitators, coordination between facilities, sensitivity training for younger persons, detailed advertisements, and appropriate activities for different age groups. Findings inform future practice and research, highlighting that IGPs are an effective strategy to alleviate negative health outcomes for seniors in RCHs. Future research is needed to evaluate long-term effects and further health outcomes. IGPs provide an opportunity to facilitate purposeful and reciprocal relationships between generations, fostering intergenerational understanding. By studying IGPs and intergenerational interactions, we can better determine practices that meaningfully engage elders in RCHs in Canada.

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