scholarly journals Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice

2020 ◽  
Author(s):  
Carolyn Presley ◽  
Jessica Krok-Schoen ◽  
Sarah Wall ◽  
Anne Noonan ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Multidisciplinary Approach ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Geriatric Oncology ◽  
Clinic Visit ◽  
Sensory Loss ◽  
Multiple Chronic Conditions ◽  
Care Clinic ◽  
Oncology Care

Abstract Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes of older adults. However, there are still gaps between knowledge and practice for older adults with cancer.Methods: Here we provide a detailed methodology of geriatric oncology care delivery within a single institution. The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). The multidisciplinary team assesses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic consultative model is a novel approach integrating cancer subspecialties with geriatric oncology healthcare delivery.Conclusions: Older adults with cancer have a unique needs that independent of routine oncology care. The CARE clinic model provides specific assessments and interventions to improve outcomes among older adults with cancer.

scholarly journals Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice

2020 ◽  
Author(s):  
Carolyn Presley ◽  
Jessica Krok-Schoen ◽  
Sarah Wall ◽  
Anne Noonan ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Outcomes ◽  
Multidisciplinary Approach ◽  
Healthcare Delivery ◽  
Geriatric Oncology ◽  
Sensory Loss ◽  
Multiple Chronic Conditions ◽  
Care Clinic ◽  
Oncology Care ◽  
Improve Health

Abstract Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes for older adults. However, there are still gaps between knowledge and practice for older adults with cancer.Methods: Here we provide a detailed methodology of geriatric oncology care delivery within a single institution. The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). The multidisciplinary team assesses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic consultative model is a novel approach integrating cancer subspecialties with geriatric oncology healthcare delivery.Conclusions: Older adults with cancer have unique needs that are independent of routine oncology care. The CARE clinic model provides specific assessments and interventions to improve health outcomes among older adults with cancer.

scholarly journals Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice

2019 ◽  
Author(s):  
Carolyn Presley ◽  
Jessica Krok-Schoen ◽  
Sarah Wall ◽  
Anne Noonan ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Multidisciplinary Approach ◽  
Geriatric Oncology ◽  
Clinic Visit ◽  
Sensory Loss ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Multiple Chronic Conditions ◽  
Care Clinic

Abstract Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes of older adults. However, there are still gaps between knowledge and practice for older adults with cancer. Methods: The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). We review the influence of these factors across the cancer care trajectory, including at screening, diagnosis, and treatment and discuss ways in which these conditions may be targeted to improve cancer care in older adults. Results: The CARE clinic was implemented at The Ohio State University Comprehensive Cancer Center (OSUCCC) and targets modifiable risk factors affecting outcomes in older adults with cancer: weight loss, polypharmacy, physical impairments, social support, and mood symptoms. The multidisciplinary team at the CARE clinic discusses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic is part of a set of initiatives that feature education of future leaders in geriatric oncology, survivorship care for an aging population, and outcomes research. Conclusions: Older adults with cancer have a unique set of needs that need to be taken into account throughout their cancer care. The CARE clinic model is an important example of an approach that may combat these difficulties and lead to better outcomes among older adults with cancer.

scholarly journals Implementing a Multidisciplinary Approach for Older Adults with Cancer: Geriatric Oncology in Practice

2020 ◽  
Author(s):  
Carolyn Presley ◽  
Jessica Krok-Schoen ◽  
Sarah Wall ◽  
Anne Noonan ◽  
Desiree Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Cancer Care ◽  
Multidisciplinary Approach ◽  
Geriatric Oncology ◽  
Clinic Visit ◽  
Sensory Loss ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Multiple Chronic Conditions ◽  
Care Clinic

Abstract Background: Evidence-based practice in geriatric oncology is growing, and national initiatives have focused on expanding cancer care and research to improve health outcomes of older adults. However, there are still gaps between knowledge and practice for older adults with cancer. Methods: The Cancer and Aging Resiliency (CARE) clinic is a multidisciplinary approach for implementing geriatric-driven health care for older adults with cancer. The CARE clinic was developed as a direct response to recommendations targeting key multifactorial geriatric health conditions (e.g. falls, nutritional deficits, sensory loss, cognitive impairment, frailty, multiple chronic conditions, and functional status). We review the influence of these factors across the cancer care trajectory, including at screening, diagnosis, and treatment and discuss ways in which these conditions may be targeted to improve cancer care in older adults. Results: The CARE clinic was implemented at The Ohio State University Comprehensive Cancer Center (OSUCCC) and targets modifiable risk factors affecting outcomes in older adults with cancer: weight loss, polypharmacy, physical impairments, social support, and mood symptoms. The multidisciplinary team at the CARE clinic discusses and delivers a comprehensive set of recommendations, all in one clinic visit, to minimize burden on the patient and the caregiver. The CARE clinic is part of a set of initiatives that feature education of future leaders in geriatric oncology, survivorship care for an aging population, and outcomes research. Conclusions: Older adults with cancer have a unique set of needs that need to be taken into account throughout their cancer care. The CARE clinic model is an important example of an approach that may combat these difficulties and lead to better outcomes among older adults with cancer.

scholarly journals HEALTHCARE PROVIDERS’ EXPERIENCES IN CARING FOR OLDER ADULTS WITH MULTIPLE CHRONIC CONDITIONS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S317-S318
Author(s):  
Jenny Ploeg ◽  
Marie-Lee Yous ◽  
Kimberly Fraser ◽  
Sinéad Dufour ◽  
Sharon Kaasalainen ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Home Care ◽  
Family Caregivers ◽  
Chronic Conditions ◽  
Care Delivery ◽  
Healthcare Providers ◽  
Multiple Chronic Conditions ◽  
Team Approach ◽  
Personal Support

Abstract The management of multiple chronic conditions (MCC) in older adults living in the community is complex. Little is known about the experiences of interdisciplinary primary care and home providers who care for this vulnerable group. The aim of this study was to explore the experiences of healthcare providers in managing the care of community-living older adults with MCC and to highlight their recommendations for improving care delivery for this group. A qualitative interpretive description design was used. A total of 42 healthcare providers from two provinces in Canada participated in semi-structured interviews. Participants represented diverse disciplines (e.g., physicians, nurses, social workers, personal support workers) and settings (e.g., primary care and home care). Thematic analysis was used to analyze interview data. The experiences of healthcare providers managing care for older adults with MCC were organized into six major themes: (1) managing complexity associated with MCC, (2) implementing person-centred care, (3), involving and supporting family caregivers, (4) using a team approach for holistic care delivery, (5) encountering rewards and challenges in caring for older adults with MCC, and (6) recommending ways to address the challenges of the healthcare system. Healthcare providers highlighted the need for a more comprehensive integrated system of care to improve care management for older adults with MCC and their family caregivers. Specifically, they suggested increased care coordination, more comprehensive primary care visits with an interprofessional team, and increased home care support.

scholarly journals The Heart Failure Readmission Intervention by Variable Early Follow-up (THRIVE) Study

2020 ◽  
Vol 13 (10) ◽  
Author(s):  
Keane K. Lee ◽  
Rachel C. Thomas ◽  
Thida C. Tan ◽  
Thomas K. Leong ◽  
Anthony Steimle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care Physicians ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Clinic Visit ◽  
Heart Failure Hospitalization ◽  
Healthcare Delivery System ◽  
Unique Identifier ◽  
Clinic Visits

Background: In-person clinic follow-up within 7 days after discharge from a heart failure hospitalization is associated with lower 30-day readmission. However, health systems and patients may find it difficult to complete an early postdischarge clinic visit, especially during the current pandemic. We evaluated the effect on 30-day readmission and death of follow-up within 7 days postdischarge guided by an initial structured nonphysician telephone visit compared with follow-up guided by an initial clinic visit with a physician. Methods and Results: We conducted a pragmatic randomized trial in a large integrated healthcare delivery system. Adults being discharged home after hospitalization for heart failure were randomly assigned to either an initial telephone visit with a nurse or pharmacist to guide follow-up or an initial in-person clinic appointment with primary care physicians providing usual care within the first 7 days postdischarge. Telephone appointments included a structured protocol enabling medication titration, laboratory ordering, and booking urgent clinic visits as needed under physician supervision. Outcomes included 30-day readmissions and death and frequency and type of completed follow-up within 7 days of discharge. Among 2091 participants (mean age 78 years, 44% women), there were no significant differences in 30-day heart failure readmission (8.6% telephone, 10.6% clinic, P =0.11), all-cause readmission (18.8% telephone, 20.6% clinic, P =0.30), and all-cause death (4.0% telephone, 4.6% clinic, P =0.49). Completed 7-day follow-up was higher in 1027 patients randomized to telephone follow-up (92%) compared with 1064 patients assigned to physician clinic follow-up (79%, P <0.001). Overall frequency of clinic visits during the first 7 days postdischarge was lower in participants assigned to nonphysician telephone guided follow-up (48%) compared with physician clinic-guided follow-up (77%, P <0.001). Conclusions: Early, structured telephone follow-up after hospitalization for heart failure can increase 7-day follow-up and reduce in-person visits with comparable 30-day clinical outcomes within an integrated care delivery framework. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT03524534.

scholarly journals Investigating the effectiveness of care delivery at an acute geriatric community hospital for older adults in the Netherlands: a protocol for a prospective controlled observational study

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033802
Author(s):  
Marthe E Ribbink ◽  
Janet L Macneil-Vroomen ◽  
Rosanne van Seben ◽  
Irène Oudejans ◽  
Bianca M Buurman
Keyword(s):  
Older Adults ◽  
The Netherlands ◽  
Community Hospital ◽  
Care Delivery ◽  
Functional Decline ◽  
Transitions Of Care ◽  
Multiple Chronic Conditions ◽  
Hospitalised Patients ◽  
Ethics Research ◽  
Effectiveness Of Care

IntroductionHospital admission in older adults with multiple chronic conditions is associated with unwanted outcomes like readmission, institutionalisation, functional decline and mortality. Providing acute care in the community and integrating effective components of care models might lead to a reduction in negative outcomes. Recently, the first geriatrician-led Acute Geriatric Community Hospital (AGCH) was introduced in the Netherlands. Care at the AGCH is focused on the treatment of acute diseases, comprehensive geriatric assessment, setting patient-led goals, early rehabilitation and streamlined transitions of care.Methods and analysisThis prospective cohort study will investigate the effectiveness of care delivery at the AGCH on patient outcomes by comparing AGCH patients to two historic cohorts of hospitalised patients. Propensity score matching will correct for potential population differences. The primary outcome is the 3-month unplanned readmission rate. Secondary outcomes include functional decline, institutionalisation, healthcare utilisation, occurrence of delirium or falls, health-related quality of life, mortality and patient satisfaction. Measurements will be conducted at admission, discharge and 1, 3 and 6 months after discharge. Furthermore, an economic evaluation and qualitative process evaluation to assess facilitators and barriers to implementation are planned.Ethics and disseminationThe study will be conducted according to the Declaration of Helsinki. The Medical Ethics Research Committee confirmed that the Medical Research Involving Human Subjects Act did not apply to this research project and official approval was not required. The findings of this study will be disseminated through public lectures, scientific conferences and journal publications. Furthermore, the findings of this study will aid in the implementation and financing of this concept (inter)nationally.Trial registration numberNL7896; Pre-results.

scholarly journals “In Our Corner”: A Qualitative Descriptive Study of Patient Engagement in a Community-Based Care Coordination Program

2016 ◽  
Vol 27 (3) ◽  
pp. 258-277 ◽  
Author(s):  
Justine S. Sefcik ◽  
Darina Petrovsky ◽  
Megan Streur ◽  
Mark Toles ◽  
Melissa O’Connor ◽  
...  
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Care Coordination ◽  
Patient Engagement ◽  
Care Delivery ◽  
Care Utilization ◽  
Multiple Chronic Conditions ◽  
Analytical Technique ◽  
Increased Risk ◽  
Qualitative Descriptive

The purpose of this study was to explore participants’ experience in the Health Quality Partners (HQP) Care Coordination Program that contributed to their continued engagement. Older adults with multiple chronic conditions often have limited engagement in health care services and face fragmented health care delivery. This can lead to increased risk for disability, mortality, poor quality of life, and increased health care utilization. A qualitative descriptive design with two focus groups was conducted with a total of 20 older adults enrolled in HQP’s Care Coordination Program. Conventional content analysis was the analytical technique. The overarching theme resulting from the analysis was “in our corner,” with subthemes “opportunities to learn and socialize” and “dedicated nurses,” suggesting that these are the primary contributing factors to engagement in HQP’s Care Coordination Program. Study findings suggest that nurses play an integral role in patient engagement among older adults enrolled in a care coordination program.

Aging Brain Care

2017 ◽  
Author(s):  
Catherine A. Alder ◽  
Mary Guerriero Austrom ◽  
Michael A. LaMantia ◽  
Malaz A. Boustani
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Care Delivery ◽  
Health Care Delivery System ◽  
Care Plan ◽  
Aging Brain ◽  
Multiple Chronic Conditions ◽  
Late Life Depression ◽  
Medical Provider ◽  
Holistic View

While fragmented care is a problem across the entire health care delivery system, it is especially problematic for vulnerable older adults with dementia and late-life depression. Most older adults have multiple chronic conditions. Cognitive impairment and mood disorders complicate the management of these comorbid conditions by interfering with the patient’s ability to monitor and report symptoms and comply with the care plan. To reduce fragmentation and promote integrated care, each medical provider must adopt a more holistic view of health care, recognizing the importance of communication and collaboration among all providers and the potential impact of any one action on the patient’s overall health. The Aging Brain Care (ABC) model provides a structure for integrating evidence-based interventions for dementia and depression into the primary care environment. By extending the delivery of care beyond the clinic, ABC offers patient-centered services aimed at coordinating care across multiple providers, settings, and community resources.

scholarly journals Implementing a multidisciplinary approach for older adults with Cancer: geriatric oncology in practice

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Carolyn J. Presley ◽  
Jessica L. Krok-Schoen ◽  
Sarah A. Wall ◽  
Anne M. Noonan ◽  
Desiree C. Jones ◽  
...  
Keyword(s):  
Older Adults ◽  
Multidisciplinary Approach ◽  
Geriatric Oncology

Older adults' views on their person-centred care needs in a long-term care setting in Ireland

2019 ◽  
Vol 28 (9) ◽  
pp. 552-557 ◽  
Author(s):  
Fiona Kelly ◽  
Mary Reidy ◽  
Suzanne Denieffe ◽  
Catherine Madden
Keyword(s):  
Older Adults ◽  
Care Setting ◽  
Long Term Care ◽  
Care Delivery ◽  
Healthcare Delivery ◽  
Cross Sectional Study ◽  
Care Needs ◽  
Cross Sectional ◽  
Term Care

Background: person-centred care should be responsive to the needs of older adults in long-term care. It is central to collaborative and high-quality healthcare delivery. Aim: to explore the perceptions of older Irish adults aged 65 years of age or more regarding the person-centred climate of the long-term care setting in which they live. Method: a cross-sectional study design using the Person-centered Climate Questionnaire–Patient (PCQ-P) was used to survey 56 older adults in a long-term care setting. Results: overall, residents considered the setting to be hospitable, welcoming, clean and safe; the mean (SD) scale score was 5.39 (0.520). Psychosocial concerns about adapting to living in long-term care environments need to be addressed, particularly among the younger male residents when compared with older male residents (53.8% v 86.7%, P=0.018). Conclusion: older people in long-term care may prioritise different facets of person-centredness to staff. Further research of approaches used in Irish older adult long-term person-centred care delivery is warranted.

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