APPROPRIATE PRESCRIBING FOR OLDER PEOPLE: A NEW TOOL FOR THE GENERAL PRACTITIONER

Background:Appropriate prescribing for older people is a challenge. General practitioners (GPs) areaware of their key position in relation to prescribing practice in the elderly. However, they often feel powerlessand report a need for simple GP friendly tools to assess and support their prescribing practice. Objectives: In thisstudy such a tool is developed: the Appropriate Medication for Older people-tool (AMO-tool). The purpose of thestudy is to investigate whether GPs consider the use of the AMO-tool to be practically feasible and resulting inmore appropriate prescribing. Design:This pilot study with an interventional design was conducted over a periodof six months. Setting:The study was conducted in nursing homes visited by GPs. Participants:The studiedpopulation consisted of nine GPs and 67 nursing home residents. Intervention:The intervention consisted of theuse of the AMO-tool. Measurements:The Short Form (SF)-12 questionnaire was administered to the patients.Patients' medication lists were recorded. The GPs completed a semi-quantitative questionnaire on theirexperiences with the AMO-tool. A descriptive qualitative and semi-quantitative analysis was carried out on theGP questionnaire. The results of the SF-12 questionnaires and medication lists were analysed quantitatively. Amultivariate analysis was carried out. Results: In the perception of GPs, applying the AMO-tool to medicationlists of nursing home residents was feasible and resulted in more appropriate prescribing. A slight reduction wasrecorded in the number of medications prescribed. Self-reported well-being improved and rose in parallel withthe number of medication changes. Conclusion:According to GPs, the AMO-tool offers GPs the support in theirprescribing practice. Changes are made to medication lists and improvements occur in patients' self-reportedwell-being. Future research should objectify the appropriateness of prescriptions before and after using the tool.Furthermore, it should investigate the possible causal relationship between the use of the AMO-tool, an increasein appropriateness of medication lists and an improvement of general well-being.

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The Role of Nursing Homes Architectural Design in Mitigating the Risk of COVID-19 Pandemics: The Case of Slovenia

Athens Journal of Architecture ◽

10.30958/aja.8-1-3 ◽

2022 ◽

Vol 8 (1) ◽

pp. 51-66

Author(s):

Vesna Žegarac Leskovar ◽

Vanja Skalicky Klemenčič

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Older People ◽

Architectural Design ◽

Nursing Home Residents ◽

The Elderly ◽

Evaluation Tool ◽

Negative Effect ◽

Disproportionate Number ◽

Role Of Nursing

Currently, many older people live in institutions for various social and health reasons. In Slovenia, this proportion is almost 5% of the population aged 65 and over. In the COVID-19 pandemic, the elderly proved to be the most vulnerable social group, as they are exposed to a number of comorbidities that increase the risk of mortality. At that time, nursing homes represented one of the most critical types of housing, as seen from a disproportionate number of infections and deaths among nursing home residents worldwide, including Slovenia. During the emergency, a number of safety protocols had to be followed to prevent the spread of infection. Unfortunately, it turned out that while the safety measures protected the nursing home residents, they also had a negative effect on their mental health, mainly due to isolation and social distancing. It follows that especially in times of epidemics of infectious respiratory diseases, the quality of life in nursing homes requires special attention. In this context, it is also necessary to consider whether and how an appropriate architectural design can help mitigating the spread of infections, while at the same time enable older people to live in dignity and with a minimum of social exclusion. To this end, the present study examined 97 nursing homes in Slovenia, analysing the number of infections in nursing homes and their correlation with the degree of infection in the corresponding region in Slovenia. Additionally, 2 nursing homes were studied in more detail with the use of newly developed “Safe and Connected” evaluation tool, analysing the architectural features of each building. The advantages identified so far include living in smaller units, single rooms with balconies, the possibility of using green open spaces and the use of an adequate ventilation. Conclusions of this study are useful for further consideration of design of new nursing homes and the refurbishment of existing ones.

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OPTIMISM, QUALITY OF LIFE, AND COGNITION IN RECENT NURSING HOME RESIDENTS

Innovation in Aging ◽

10.1093/geroni/igz038.419 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S113-S113

Author(s):

Diana DiGasbarro ◽

Kimberly Van Haitsma ◽

Suzanne Meeks ◽

Benjamin T Mast

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Nursing Home ◽

Cognitive Impairment ◽

Nursing Home Residents ◽

Dispositional Optimism ◽

Well Being ◽

Future Research ◽

The Relationship

Abstract Dispositional optimism may be an important resource for well-being across the lifespan. However, the relationship between optimism and quality of life in recent nursing home residents with and without cognitive impairment has not been examined. The aim of this study is to fill this gap in a sample of 66 older adults with a mean age of 74.59 years old (SD=10.37) who were admitted to a nursing home within the previous 30 days. Sixty older adults completed measures of cognition, quality of life, and optimism, and thus were included in analysis for the current study. Participants were split into groups based on the presence or absence of cognitive impairment, and linear regressions were conducted to examine the relationship between optimism and quality of life. In recent nursing home residents without cognitive impairment (n=30), optimism did not predict quality of life and accounted for a very small amount of variance (R2=.042, p=.280). However, in recent nursing home residents with cognitive impairment (n=32), optimism accounted for 20.9% of the variance in quality of life (R2=.209, p=.009). Higher levels of optimism were associated with better quality of life. Future research should explore why a stable trait like dispositional optimism is a stronger predictor of quality of life in recent nursing home residents with cognitive impairment compared to those without cognitive impairment. This line of research would be synergistic with emerging research on the identification and encouragement of strengths in older adults with cognitive impairment.

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The Psychological Consequences of the COVID-19 on Residents and Staff in Nursing Homes

Work Aging and Retirement ◽

10.1093/workar/waaa021 ◽

2020 ◽

Vol 6 (4) ◽

pp. 254-259

Author(s):

Shenjiang Mo ◽

Junqi Shi

Keyword(s):

Nursing Home ◽

Nursing Homes ◽

Older People ◽

Nursing Home Residents ◽

Future Research ◽

Psychological Consequences ◽

Ethical Challenges ◽

Role Conflicts ◽

External Stakeholders

Abstract In this commentary, we overview the existing research on psychological consequences caused by COVID-19 for both residents and staff in the nursing homes. We identify loneliness and emotional anxiety as main psychological consequences for nursing home residents, whereas uncertainty, hopelessness, work overload, and role conflicts are the most salient psychological challenges for the staff in the nursing homes during the pandemic. We then summarize the existing strategies and interventions responsive to the above challenges. We suggest that this overview may help nursing home managers understand what are the key psychological challenges and how to deal with them during a crisis period. Finally, we also encourage future research to pay more attention to exploring interventions specifically designed for vulnerable older people, understanding the role of the nursing home leader team in managing emotional and ethical challenges in organizations, and developing community-wide collaboration with multiple external stakeholders.

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Multicomponent exercise to improve motor functions, cognition and well-being for nursing home residents who are unable to walk – A randomized controlled trial

Experimental Gerontology ◽

10.1016/j.exger.2021.111484 ◽

2021 ◽

pp. 111484

Author(s):

Thomas Cordes ◽

Katharina Zwingmann ◽

Julian Rudisch ◽

Claudia Voelcker-Rehage ◽

Bettina Wollesen

Keyword(s):

Randomized Controlled Trial ◽

Nursing Home ◽

Controlled Trial ◽

Nursing Home Residents ◽

Well Being ◽

Motor Functions ◽

Randomized Controlled

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Sex with robots: A not-so-niche market for disabled and older persons

Paladyn Journal of Behavioral Robotics ◽

10.1515/pjbr-2020-0009 ◽

2020 ◽

Vol 11 (1) ◽

pp. 228-232

Author(s):

Adamantios Koumpis ◽

Thomas Gees

Keyword(s):

Artificial Intelligence ◽

Older People ◽

Older Persons ◽

Well Being ◽

The Elderly ◽

Deep Roots ◽

Value System ◽

Sex Robots ◽

Per Se ◽

Sex Toys

AbstractIn this article, we present our experiences from research into the healthy ageing and well-being of older people and we report on our personal opinions of robots that may help the elderly to have sex and to cope with isolation and loneliness. However, and while there is a growing industry for sex robots and other sex toys and gadgets, there is also a growing concern about the ethics of such an industry. As is the case with pornography, the concept of sex robots may be criticized, yet it has deep roots in human civilization, with erotic depictions that date back to the Palaeolithic and Mesolithic Ages. So the need for an artefact that would offer sexually relevant functionality is not new at all. But what might be new and worrying is the potential for using artificial intelligence in sex robots in ways that might cause a repositioning of our entire value system. Such a threat is not related to the proliferation of sex robots per se but to the use of robots in general and in a variety of other fields of application.

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Benzodiazepine-Induced and Anticholinergic-Induced Delirium in the Elderly

International Psychogeriatrics ◽

10.1017/s1041610291000832 ◽

1991 ◽

Vol 3 (2) ◽

pp. 397-408 ◽

Cited By ~ 56

Author(s):

Larry E. Tune ◽

Fred W. Bylsma

Keyword(s):

Nursing Home ◽

Cognitive Impairments ◽

Anticholinergic Drug ◽

Nursing Home Residents ◽

The Elderly ◽

Quantitative Eeg ◽

Extensive Literature ◽

Drug Levels ◽

Patient Morbidity ◽

Increasing Risk

Encompassing the range from subtle cognitive impairments to frank delirium, toxicity due to benzodiazepines and to anticholinergic-containing compounds is reviewed. For benzodiazepines, an extensive literature suggests that they impair immediate and delayed memory, psychomotor performance, and subjective complaints of station. This, in several studies, results in increased patient morbidity (e.g., increasing risk of hip fractures). Anticholinergic compounds are widely utilized in managing elderly patients, particularly nursing home residents. Toxicity from anticholinergic compounds, detected by anticholinergic drug levels, is significantly correlated with the presence and severity of delirium in a number of settings including postoperative patients and elderly nursing home residents. Possible means of identifying the syndrome by prediction of dose and type of medication, as well as by quantitative EEG, are reviewed.

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The economic recession and subjective well-being in older adults in the Republic of Ireland

Irish Journal of Psychological Medicine ◽

10.1017/ipm.2016.21 ◽

2016 ◽

Vol 36 (2) ◽

pp. 99-104 ◽

Cited By ~ 1

Author(s):

R. M. Duffy ◽

K. Mullin ◽

S. O’Dwyer ◽

M. Wrigley ◽

B. D. Kelly

Keyword(s):

Older Adults ◽

Older People ◽

Urban Areas ◽

Economic Recession ◽

Well Being ◽

Poor Health ◽

Future Research ◽

Subjective Well Being ◽

Physical And Mental Health ◽

Future Health

ObjectiveSubjective well-being in older people is strongly associated with emotional, physical and mental health. This study investigates subjective well-being in older adults in Ireland before and after the economic recession that commenced in 2008.MethodsCross-sectional data from the biennial European Social Survey (2002–2012) were analysed for two separate groups of older adults: one sampled before the recession and one after. Stratification and linear regression modelling were used to analyse the association between subjective well-being, the recession and multiple potential confounders and effect modifiers.ResultsData were analysed on 2013 individuals. Overall, subjective well-being among older adults was 1.30 points lower after the recession compared with before the recession (s.e. 0.16; 95% confidence interval 1.00–1.61; p<0.001) [pre-recession: 16.1, out of a possible 20 (s.d. 3.24); post-recession:14.8 (s.d. 3.72)]. Among these older adults, the pre- and post-recession difference was especially marked in women, those with poor health and those living in urban areas.ConclusionsSubjective well-being was significantly lower in older adults after the recession compared with before the recession, especially in women with poor health in urban areas. Policy-makers need proactively to protect these vulnerable cohorts in future health and social policy. Future research could usefully focus on older people on fixed incomes whose diminished ability to alter their economic situation might make them more vulnerable to reduced subjective well-being during a recession.

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